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Published in: Journal of Neuro-Oncology 3/2010

01-02-2010 | Clinical Study - Patient Study

Imaging response criteria for recurrent gliomas treated with bevacizumab: Role of diffusion weighted imaging as an imaging biomarker

Authors: Rajan Jain, Lisa M. Scarpace, Shehanaz Ellika, Roy Torcuator, Lonni R. Schultz, David Hearshen, Tom Mikkelsen

Published in: Journal of Neuro-Oncology | Issue 3/2010

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Abstract

The purpose of this study was to assess the usefulness of diffusion weighted imaging as an additional imaging biomarker for treatment response in recurrent/progressive malignant gliomas treated with bevacizumab alone or in combination with other chemotherapeutic agents. Twenty patients treated with bevacizumab alone or concurrent chemotherapy were followed up with serial MR imaging. Volume and ADC values of contrast enhancing lesion (CELvol, CELADC) and also of non-enhancing lesion (NELvol, NELADC) were obtained. CELvol showed a progressive decrease in non-progressors with a median percentage change of −73.2% (P = 0.001) as compared to −33.4% for progressors by 1 year/last imaging (P = 0.382). NELvol also showed a decrease in non-progressors on follow up imaging though only significant for 3 months follow up (P = 0.042). In progressors, CELvol and NELvol showed initial decrease followed by slight increase by 1 year/last imaging though not significant (P value of 0.382 and 0.46, respectively). CELADC and NELADC in non-progressors did not show any statistically significant change though there was slight trend for positive percent change especially for CELADC by 1 year/last imaging follow up study (P value of 0.077 and 0.339, respectively). Progressors showed a progressive negative percent change of CELADC and NELADC. In progressors, NELADC decreased at 6 weeks (P = 0.054), 3 months (P = 0.023) and 1 year/last (P = 0.078) as compared to baseline study and was also statistically significant as compared to non-progressors at 6 weeks (P = 0.047) and 3 months (P = 0.025). CELADC and NELADC appear to follow different trends over time for non-progressors and progressors with a stable to slightly progressive increase in non-progressors and a progressive decrease in progressors, especially early on. These findings suggest that DWI may be used as an additional imaging biomarker for early treatment response.
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Metadata
Title
Imaging response criteria for recurrent gliomas treated with bevacizumab: Role of diffusion weighted imaging as an imaging biomarker
Authors
Rajan Jain
Lisa M. Scarpace
Shehanaz Ellika
Roy Torcuator
Lonni R. Schultz
David Hearshen
Tom Mikkelsen
Publication date
01-02-2010
Publisher
Springer US
Published in
Journal of Neuro-Oncology / Issue 3/2010
Print ISSN: 0167-594X
Electronic ISSN: 1573-7373
DOI
https://doi.org/10.1007/s11060-009-9981-6

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