
==== Front
Neurooncol Adv
Neurooncol Adv
noa
Neuro-Oncology Advances
2632-2498
Oxford University Press US

10.1093/noajnl/vdae090.074
vdae090.074
Final Category: Neuroimaging/Radiologic Advances
AcademicSubjects/MED00300
AcademicSubjects/MED00310
NIRL-13 HISTOPATHOLOGIC CONFIRMATION OF TUMOR RECURRENCE IDENTIFIED ON CONTRAST CLEARANCE ANALYSIS MAPS - A VALIDATION STUDY
Madhugiri Venkatesh Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Goulenko Victor Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Bregdy Amade Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Recker Matthew Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Lipinski Lindsay Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Fabiano Andrew Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Fenstermaker Robert Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Plunkett Robert Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Abad Ajay Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Belal Ahmed Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Alberico Ronald Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Qiu Jingxin Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

Prasad Dheerendra Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA

8 2024
02 8 2024
02 8 2024
6 Suppl 1 2024 SNO/ASCO CNS Metastases Conference i22i23
© The Author(s) 2024. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.
2024
https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

Abstract

BACKGROUND

Stereotactic radiosurgery (SRS) has become a standard modality in the treatment of brain metastases. The differentiation between adverse radiation effects (ARE) and tumor recurrence or progression is important in this setting. The advent of immunotherapy and targeted therapy often makes this distinction difficult to achieve. Contrast clearance analysis (CCA) is a useful technique that can inform clinical decisions but has so far only been histologically validated in the context of high-grade gliomas.

METHODS

Between 2018 and 2023, more than 200 patients who had been treated with SRS for various brain pathologies including brain metastasis, atypical meningiomas, and high-grade gliomas underwent CCA studies. Among these patients, clinical scenarios mandated surgery in 7 patients. Targeted biopsies were taken at the time of surgery in all patients. Histopathology findings were compared with the CCA findings in these patients.

RESULTS

All 7 patients had been treated with gamma knife radiosurgery and were being followed up with periodic MR imaging. All patients underwent CCA when the necessity to distinguish tumor recurrence from ARE/ radiation necrosis arose. Targeted biopsies showed 100% concordance of the pre-surgery CCA findings with histological findings. Viable tumor tissue was identified on pathology in all instances where the CA map indicated the presence of viable tumor represented in blue color.

CONCLUSIONS

Based on prior studies on GBM and the surgical findings in our series, delayed contrast extravasation MRI findings correlate well with histopathology. CCA can provide a quick diagnosis and have a direct impact on patient treatment and outcomes.
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