Andreas Stadlbauer1, Petra Pichler2, Marianne Karl3, Sebastian Brandner4, Claudia Lerch3, Bertold Renner5, Gertraud Heinz3. 1. Institute of Medical Radiology, University Clinic of St. Pölten, Propst Führer-Straße 4, A-3100 St. Pölten, Austria; Department of Neurosurgery, University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany; Department of Radiology and Nuclear Medicine, Medical University Vienna, Währinger Gürtel 18-20, A-1097 Vienna, Austria. Electronic address: andi@nmr.at. 2. First Department of Internal Medicine, University Clinic of St. Pölten, Propst Führer-Straße 4, A-3100 St. Poelten, Austria. 3. Institute of Medical Radiology, University Clinic of St. Pölten, Propst Führer-Straße 4, A-3100 St. Pölten, Austria. 4. Department of Neurosurgery, University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany. 5. Institute of Experimental and Clinical Pharmacology and Toxicology, University of Erlangen-Nürnberg, Erlangen, Germany.
Abstract
OBJECTIVES: To evaluate the usefulness of quantitative advanced magnetic resonance imaging (MRI) methods for assessment of antiangiogenic therapy (AAT) response in recurrent glioblastoma multiforme (GBM). METHODS: Eighteen patients with recurrent GBM received bevacizumab and 18 patients served as control group. Baseline MRI and two follow-up examinations were acquired every 3-5 months using dynamic susceptibility-weighted contrast (DSC) perfusion MRI and (1)H-MR spectroscopic imaging ((1)H-MRSI). Maps of absolute cerebral blood volume (aCBV) were coregistered with choline (Cho) and N-acetyl-aspartate (NAA) concentrations and compared to usually used relative parameters as well as controls. RESULTS: Perfusion significantly decreased in responding and pseudoresponding GBMs but also in normal appearing brain after AAT onset. Cho and NAA concentrations were superior to Cr-ratios in lesion differentiation and showed a clear gap between responding and pseudoresponding lesions. Responders to AAT exceptionally frequently (6 out of 8 patients) showed remote GBM progression. CONCLUSIONS: Quantification of CBV reveals changes in normal brain perfusion due to AAT, which were not described so far. DSC perfusion MRI seems not to be suitable for differentiation between response and pseudoresponse to AAT. However, absolute quantification of brain metabolites may allow for distinction due to a clear gap at 6-9 months after therapy onset.
OBJECTIVES: To evaluate the usefulness of quantitative advanced magnetic resonance imaging (MRI) methods for assessment of antiangiogenic therapy (AAT) response in recurrent glioblastoma multiforme (GBM). METHODS: Eighteen patients with recurrent GBM received bevacizumab and 18 patients served as control group. Baseline MRI and two follow-up examinations were acquired every 3-5 months using dynamic susceptibility-weighted contrast (DSC) perfusion MRI and (1)H-MR spectroscopic imaging ((1)H-MRSI). Maps of absolute cerebral blood volume (aCBV) were coregistered with choline (Cho) and N-acetyl-aspartate (NAA) concentrations and compared to usually used relative parameters as well as controls. RESULTS: Perfusion significantly decreased in responding and pseudoresponding GBMs but also in normal appearing brain after AAT onset. Cho and NAA concentrations were superior to Cr-ratios in lesion differentiation and showed a clear gap between responding and pseudoresponding lesions. Responders to AAT exceptionally frequently (6 out of 8 patients) showed remote GBM progression. CONCLUSIONS: Quantification of CBV reveals changes in normal brain perfusion due to AAT, which were not described so far. DSC perfusion MRI seems not to be suitable for differentiation between response and pseudoresponse to AAT. However, absolute quantification of brain metabolites may allow for distinction due to a clear gap at 6-9 months after therapy onset.
Authors: R Singh; K Kesavabhotla; S A Kishore; Z Zhou; A J Tsiouris; C G Filippi; J A Boockvar; I Kovanlikaya Journal: AJNR Am J Neuroradiol Date: 2016-05-26 Impact factor: 3.825
Authors: T J Yun; H R Cho; S H Choi; H Kim; J-K Won; S-W Park; J-H Kim; C-H Sohn; M H Han Journal: AJNR Am J Neuroradiol Date: 2016-05-12 Impact factor: 3.825
Authors: Tineke van de Weijer; Martijn P G Broen; Rik P M Moonen; Ann Hoeben; Monique Anten; Koos Hovinga; Inge Compter; Jochem A J van der Pol; Cristina Mitea; Toine M Lodewick; Arnaud Jacquerie; Felix M Mottaghy; Joachim E Wildberger; Alida A Postma Journal: Diagnostics (Basel) Date: 2022-05-11
Authors: Otto M Henriksen; Vibeke A Larsen; Aida Muhic; Adam E Hansen; Henrik B W Larsson; Hans S Poulsen; Ian Law Journal: Eur J Nucl Med Mol Imaging Date: 2015-09-12 Impact factor: 9.236
Authors: Bart R J van Dijken; Peter Jan van Laar; Marion Smits; Jan Willem Dankbaar; Roelien H Enting; Anouk van der Hoorn Journal: J Magn Reson Imaging Date: 2019-01 Impact factor: 4.813
Authors: Pratik Talati; Mohamed El-Abtah; Daniel Kim; Jorg Dietrich; Melanie Fu; Michael Wenke; Julian He; Sharif N Natheir; Mark Vangel; Otto Rapalino; Anna Vaynrub; Isabel Arrillaga-Romany; Deborah A Forst; Yi-Fen Yen; Ovidiu Andronesi; Jayashree Kalpathy-Cramer; Bruce Rosen; Tracy T Batchelor; R Gilberto Gonzalez; Elizabeth R Gerstner; Eva-Maria Ratai Journal: Neurooncol Adv Date: 2021-04-15