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01-04-2011 | Functional Neuroradiology

ADC histograms predict response to anti-angiogenic therapy in patients with recurrent high-grade glioma

Authors: Martha Nowosielski, Wolfgang Recheis, Georg Goebel, Özgür Güler, Gerd Tinkhauser, Herwig Kostron, Michael Schocke, Thaddaeus Gotwald, Günther Stockhammer, Markus Hutterer

Published in: Neuroradiology | Issue 4/2011

Abstract

Introduction

The purpose of this study is to evaluate apparent diffusion coefficient (ADC) maps to distinguish anti-vascular and anti-tumor effects in the course of anti-angiogenic treatment of recurrent high-grade gliomas (rHGG) as compared to standard magnetic resonance imaging (MRI).

Methods

This retrospective study analyzed ADC maps from diffusion-weighted MRI in 14 rHGG patients during bevacizumab/irinotecan (B/I) therapy. Applying image segmentation, volumes of contrast-enhanced lesions in T1 sequences and of hyperintense T2 lesions (hT2) were calculated. hT2 were defined as regions of interest (ROI) and registered to corresponding ADC maps (hT2-ADC). Histograms were calculated from hT2-ADC ROIs. Thereafter, histogram asymmetry termed “skewness” was calculated and compared to progression-free survival (PFS) as defined by the Response Assessment Neuro-Oncology (RANO) Working Group criteria.

Results

At 8–12 weeks follow-up, seven (50%) patients showed a partial response, three (21.4%) patients were stable, and four (28.6%) patients progressed according to RANO criteria. hT2-ADC histograms demonstrated statistically significant changes in skewness in relation to PFS at 6 months. Patients with increasing skewness (n = 11) following B/I therapy had significantly shorter PFS than did patients with decreasing or stable skewness values (n = 3, median percentage change in skewness 54% versus −3%, p = 0.04).

Conclusion

In rHGG patients, the change in ADC histogram skewness may be predictive for treatment response early in the course of anti-angiogenic therapy and more sensitive than treatment assessment based solely on RANO criteria.

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Title: ADC histograms predict response to anti-angiogenic therapy in patients with recurrent high-grade glioma
Authors: Martha Nowosielski
Wolfgang Recheis
Georg Goebel
Özgür Güler
Gerd Tinkhauser
Herwig Kostron
Michael Schocke
Thaddaeus Gotwald
Günther Stockhammer
Markus Hutterer
Publication date: 01-04-2011
Publisher: Springer-Verlag
Published in: Neuroradiology / Issue 4/2011
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-010-0808-0

At a glance: The STEP trials

Springer Medicine

ADC histograms predict response to anti-angiogenic therapy in patients with recurrent high-grade glioma

Abstract

Introduction

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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