Differential Diagnosis between Tumor Recurrence and Treatment Response using Advanced Tracer Kinetic Model in Glioblastoma

Motivation: It is challenging to differentiate recurrent tumor from treatment response in glioblastoma. Goal(s): This study explored the issue using an advanced tracer kinetic model. Approach: Glioblastoma patients were examined using dynamic contrast-enhanced MRI and stratified into recurrent and treatment-related group based on histopathological results. Imaging data were analyzed using distributed parameter model. Results: Blood flow in lesion was significantly higher and permeability in peritumoral edema was significantly smaller in recurrent than in treatment-related group (p=0.002, 0.023). Combining two parameters together, diagnostic performance was attained at AUC (area under ROC curve) 0.93. AUC of extended-Tofts model was 0.89. Impact: With separate account of blood flow and vessel-wall permeability, advanced tracer kinetic model allowed more precise modeling the feature of tissue microenvironment, which could shed light on the difference between recurrent tumor and treatment-related response in glioblastoma.