1. 1 ADC Calculations Lars Ewell Radiation Oncology University of Arizona Medical Center 2/8/08 1

2. 2 ADC Across Slices ADC needed for entire lesion, NOT for single contour. Area/Volume needs to be accounted for. Slice spacing also can affect values.

3. 3 Imaging Protocol: First Patient Given standard treatment for GBM(resected): 2Gy/Fx  23 Fx (46Gy) + 2Gy/Fx  17 Fx (14Gy). Tx finished on 2/19/07. Total of 60Gy. This Tx alone would have enabled enrollment in protocol. Prescribed additional dose of 15 Gy to same area via Stereotactic Radio Surgery (SRS). Patient at high risk for radiation necrosis. Enrolled/scanned on 3/23/07. Scan time 1 hr 13min. Treated with 15 Gy additional radiation on 3/28/07.

4. 4 1 4 2 5 3 6 MRI Scans Used for Contouring: T2 FLAIR (?)

5. 5 1 4 2 5 3 6 MRI Scans Used for ADC Calculation – diffrad, b=0

6. 6 Comparison of Scans T2 FLAIR/Brainscan  V lesion =9.14cc b=0 Protocol Scan  Slice Thickness = 5mm b=0 Protocol Scan  Slice Spacing = 7mm