Differentiation of Pseudoprogression and True Progression Through High Field Susceptibility Weighted Imaging and R2*

Study Overview
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Brief Summary
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Using a multi-echo gradient echo sequence to calculate R2* and quantitative susceptibility maps and well as susceptibility-weighted imaging post processing the investigators hypothesize that the investigators would be able to distinguish between pseudoprogression and true progression with the use of an easily implementable sequence on clinical MRI scanners.

Detailed Description
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Post-treatment radiographic imaging change (PTRIC) is seen in approximately 50% of patients who are treated for brain neoplasms using chemotherapy and radiotherapy. PTRIC can be attributed to true disease progression or a form of benign radiographic enhancement, known in literature as pseudoprogression. Of these patients, 50% of them have benign radiographic enhancement that is usually spontaneously resolved and required no intervention. The other 50% require immediate medical intervention, or more aggressive treatment for true progression. Currently standard medical practise is to administer a prophylactic treatment of chemotherapy to all patients with PTRIC with a follow up scan 3-6 months after initial PTRIC diagnosis, leading to up to 50% of patients receiving an unneeded dose of chemotherapy. The investigators hope to take advantage of the differentiation in tissue types and vascularization between true progression tumour and pseudoprogression to be able to identify patients who would not need to be administered a prophylactic dose of chemotherapy.

Official Title
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Differentiation of Pseudoprogression and True Progression Through High Field Susceptibility Weighted Imaging and R2*

Conditions
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Radiation Injury, Radiation Necrosis

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: The subject must consent to participate. The subject must be above the age of 18. Patients must be classified as possible pseudoprogression or true progression Patients scoring >= 70 on the karnofsky performance status. Exclusion Criteria: Any subject with contraindication to an MRI procedure as listed in the Magnetic Resonance Environment Screening Questionnaire. Any subject who may be unable to tolerate the MRI environment due to physical size and/or known tendency to claustrophobia. Any subject who does not expect to be available to attend the for the required study MRI scans Patients scoring < 70 on the karnofsky performance status. Attending radiation oncologist or neurologist determines patient is no longer able to consent for themselves.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Disease Progression | R2* and susceptibility-weighted imaging venography to determine retrospectively if pseudoprogression can be distinguished from true progression | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Radiation Injury, Radiation Necrosis, Ultra-high field MRI, Susceptibility Weighted Imaging, Post-treatment radiographic imaging change