Recurrent Glioblastoma Multiforme: ADC Histogram Analysis Predicts Response to Bevacizumab Treatment

Pope, Whitney B.; Kim, Hyun J; Huo, Jing; Alger, Jeffry R.; Brown, Matthew S.; Gjertson, David W.; Sai, Victor; Young, Jonathan R.; Tekchandani, Leena; Cloughesy, Timothy F.; Mischel, Paul S.; Lai, Albert; Nghiemphu, Phioanh L.; Rahmanuddin, Syed; Goldin, Jonathan G.

doi:10.1148/radiol.2521081534

Cited by 303 publications

(255 citation statements)

References 31 publications

Supporting

Mentioning

241

Contrasting

Unclassified

Order By: Relevance

“…However, most of the IDH1 mutants had large areas of nonenhancing tumor, potentially diminishing this limitation. Although the ability to identify nonenhancing tumor with high interobserver reliability has previously been demonstrated, 46 the single-reader methodology used also is a limitation of this study. Approximately half of our patients received subtotal resection, and 12 had biopsy only.…”

Section: Discussionmentioning

confidence: 94%

Relationship between Tumor Enhancement, Edema,IDH1Mutational Status,MGMTPromoter Methylation, and Survival in Glioblastoma

Carrillo¹,

Lai²,

Nghiemphu³

et al. 2012

AJNR Am J Neuroradiol

274

203

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 94%

Relationship between Tumor Enhancement, Edema,IDH1Mutational Status,MGMTPromoter Methylation, and Survival in Glioblastoma

Carrillo¹,

Lai²,

Nghiemphu³

et al. 2012

AJNR Am J Neuroradiol

274

203

View full text Add to dashboard Cite

show abstract

“…In addition, DWI values of gliomas before treatment correlated with the probability of response to therapy with bevacizumab in a study performed by Pope et al (118). Functional diffusion maps show promise as a way of providing an early surrogate marker for FIGURE 8.…”

Section: Mrimentioning

confidence: 96%

“…In children, the percentage change of choline or NAA combined with perfusion measurements in serial MRI examinations was found to be useful in predicting tumor progression (117). Before antiangiogenic therapy, ADC analysis of gliomas tended to predict progression-free survival in recurrent glioblastoma multiforme patients (118).…”

Section: Mrimentioning

confidence: 99%

Multimodality Assessment of Brain Tumors and Tumor Recurrence

Heiss¹,

Raab²,

Lanfermann³

2011

J Nucl Med

126

View full text Add to dashboard Cite

Learning Objectives: On successful completion of this activity, participants should be able to describe (1) the differences in the information obtained by various MRI and PET modalities and (2) the best combination of imaging procedures to detect brain tumors, to define the biologic activity or malignancy of a tumor, to validate therapeutic effects, and to differentiate between recurrent tumor and tissue necrosis.Financial Disclosure: The authors of this article have indicated no relevant relationships that could be perceived as a real or apparent conflict of interest. CME Credit: SNM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing education for physicians. SNM designates each JNM continuing education article for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only credit commensurate with the extent of their participation in the activity.For CE credit, participants can access this activity through the SNM Web site (http://www.snm.org/ce_online) through October 2012.Neuroimaging plays a significant role in the diagnosis of intracranial tumors, especially brain gliomas, and must consist of an assessment of location and extent of the tumor and of its biologic activity. Therefore, morphologic imaging modalities and functional, metabolic, or molecular imaging modalities should be combined for primary diagnosis and for following the course and evaluating therapeutic effects. MRI is the gold standard for providing detailed morphologic information and can supply some additional insights into metabolism (MR spectroscopy) and perfusion (perfusion-weighted imaging) but still has limitations in identifying tumor grade, invasive growth into neighboring tissue, and treatment-induced changes, as well as recurrences. These insights can be obtained by various PET modalities, including imaging of glucose metabolism, amino acid uptake, nucleoside uptake, and hypoxia. Diagnostic accuracy can benefit from coregistration of PET results and MRI, combining the high-resolution morphologic images with the biologic information. These procedures are optimized by the newly developed combination of PET and MRI modalities, permitting the simultaneous assessment of morphologic, functional, metabolic, and molecular information on the human brain. Brai n tumors are newly formed alterations of morphology, and for their diagnosis, therefore, CT or MRI is mandatory. These imaging modalities are essential for delineating the normal and pathologic anatomy and also for assessing vascular supply and impairment of the blood-brain barrier (BBB) (perfusion-weighted imaging; contrast enhancement). Additionally, MRI is capable of giving functional information on microstructural (diffusion-weighted imaging [DWI]), physiologic, and metabolic (MR spectroscopy [MRS]) changes of tumor tissues. PET and MRI provide physiologic, biochemical, and molecular information related to tumor metabolism, proliferation rate, invasiveness, and interaction with surrounding and remote areas-informati...

show abstract

“…Therefore, it may better reflect how many pixels undergo change in ADC after treatment [8,115] . It has been demonstrated that ADC histogram analysis may be a superior and quicker biomarker of tumor response to bevacizumab than tumor volume [116] . With the spatially varying change in ADC after treatment, an ideal approach is to analyze the pixels present both before and after treatment with spatial tags to detect any change in ADC pixel by pixel.…”

Section: Adc-quantification Of Dwimentioning

confidence: 99%

Multiparametric MRI biomarkers for measuring vascular disrupting effect on cancer

Marchal¹,

2011

WJR

View full text Add to dashboard Cite

Solid malignancies have to develop their own blood supply for their aggressive growth and metastasis; a process known as tumor angiogenesis. Angiogenesis is largely involved in tumor survival, progression and spread, which are known to be significantly attributed to treatment failures. Over the past decades, efforts have been made to understand the difference between normal and tumor vessels. It has been demonstrated that tumor vasculature is structurally immature with chaotic and leaky phenotypes, which provides opportunities for developing novel anticancer strategies. Targeting tumor vasculature is not only a unique therapeutic intervention to starve neoplastic cells, but also enhances the efficacy of conventional cancer treatments. Vascular disrupting agents (VDAs) have been developed to disrupt the already existing neovasculature in actively growing tumors, cause catastrophic vascular shutdown within short time, and induce secondary tumor necrosis. VDAs are cytostatic; they can only inhibit tumor growth, but not eradicate the tumor. This novel drug mechanism has urged us to develop multiparametric imaging biomarkers to monitor early hemodynamic alterations, cellular dysfunctions and metabolic impairments before tumor dimensional changes can be detected. In this article, we review the characteristics of tumor vessels, tubulindestabilizing mechanisms of VDAs, and in vivo effects of the VDAs that have been mostly studied in preclinical studies and clinical trials. We also compare the different tumor models adopted in the preclinical studies on VDAs. Multiparametric imaging biomarkers, mainly diffusion-weighted imaging and dynamic contrast-enhanced imaging from magnetic resonance imaging, are evaluated for their potential as morphological and functional imaging biomarkers for monitoring therapeutic effects of VDAs.

show abstract

Recurrent Glioblastoma Multiforme: ADC Histogram Analysis Predicts Response to Bevacizumab Treatment

Abstract: Pretreatment ADC histogram analysis can stratify progression-free survival in bevacizumab-treated patients with recurrent GBM.

Cited by 303 publications

References 31 publications

Relationship between Tumor Enhancement, Edema,IDH1Mutational Status,MGMTPromoter Methylation, and Survival in Glioblastoma

Relationship between Tumor Enhancement, Edema,IDH1Mutational Status,MGMTPromoter Methylation, and Survival in Glioblastoma

Multimodality Assessment of Brain Tumors and Tumor Recurrence

Multiparametric MRI biomarkers for measuring vascular disrupting effect on cancer

Contact Info

Product

Resources

About