Identification of a single-dose, low-flip angle based CBV threshold for fractional tumor burden (FTB) mapping in recurrent glioblastoma

Early differentiation of tumor recurrence from post treatment radiation effects (PTRE) in glioblastoma patients would improve patient management. The purpose of this study is to identify the optimal standardized relative cerebral blood volume (sRCBV) threshold for generating fractional tumor burden (FTB) maps derived from the new consensus protocol, single-dose, low-flip angle data. To establish the threshold, low-flip angle data was compared to well-validated, double-dose, moderate-flip angle data. In summary, with the optimized threshold, the single-dose, low-flip angle approach yielded FTB maps that strongly agreed with the reference standard, providing a compelling option for clinical use.