? Integrating advanced magnetic resonance imaging (MRI) methods should better describe and delineate glioblastoma multiforme (GBM) brain tumors in preparation for radiation therapy treatment. We hypothesize that the use of these imaging modalities will result in more precise radiotherapy treatment planning. The proposed research is based upon extensive preliminary data indicating chemical shift imaging (CSI), perfusion and diffusion imaging and MR-based hypoxia mapping add additional information about tumor physiology that can be incorporated into a treatment pJan with the goal of decreasing the rate of tumor recurrence. Although regions of abnormality on T2 MRI are known to correlate with microscopic spread of tumor, some of this abnormality represents edema without malignant cells while other areas may contain a high concentration of malignant cells that should be incorporated into the treatment boost volume. While most malignant brain tumors recur within the radiation treatment fields, 20-25% of recurrences occur outside of these fields. Thus, the imaging techniques will be used to identify """"""""high-risk subvolumes"""""""" within each tumor, which may be at high risk of recurrence. After completing radiotherapy, patients will be followed with serial advanced MRI scans; the study endpoint being the first recurrence. The location of the recurrence will test the prediction of the advanced imaging methods. ? ?
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