Skip to main content
Top
Published in: Fluids and Barriers of the CNS 1/2015

Open Access 01-12-2015 | Research

Vascular endothelial growth factor blockade alters magnetic resonance imaging biomarkers of vascular function and decreases barrier permeability in a rat model of lung cancer brain metastasis

Authors: Gregory L Pishko, Leslie L Muldoon, Michael A Pagel, Daniel L Schwartz, Edward A Neuwelt

Published in: Fluids and Barriers of the CNS | Issue 1/2015

Login to get access

Abstract

Background

Blockade of vascular endothelial growth factor (VEGF) to promote vascular normalization and inhibit angiogenesis has been proposed for the treatment of brain metastases; however, vascular normalization has not been well-characterized in this disease. We investigated the effect of treatment with bevacizumab anti-VEGF antibody on magnetic resonance imaging (MRI) biomarkers of brain tumor vascular characteristics in comparison to small molecule delivery in a rat model of human lung cancer brain metastasis.

Methods

Athymic rats with A549 human lung adenocarcinoma intracerebral xenografts underwent MRI at 11.75 T before and one day after treatment with bevacizumab (n = 8) or saline control (n = 8) to evaluate tumor volume, free water content (edema), blood volume and vascular permeability (Ktrans). One day later, permeability to 14C-aminoisobutyric acid (AIB) was measured in tumor and brain to assess the penetration of a small drug-like molecule.

Results

In saline control animals, tumor volume, edema and permeability increased over the two day assessment period. Compared to controls, bevacizumab treatment slowed the rate of tumor growth (P = 0.003) and blocked the increase in edema (P = 0.033), but did not alter tumor blood volume. Bevacizumab also significantly reduced Ktrans (P = 0.033) and AIB passive permeability in tumor (P = 0.04), but not to peritumoral tissue or normal brain. Post-treatment Ktrans correlated with AIB levels in the bevacizumab-treated rats but not in the saline controls.

Conclusions

The correlation of an MRI biomarker for decreased vascular permeability with decreased AIB concentration in tumor after antiangiogenic treatment suggests that bevacizumab partially restored the normal low permeability characteristics of the blood–brain barrier in a model of human lung cancer brain metastasis.
Literature
1.
go back to reference Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE: Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol 2004, 22:2865–72. 10.1200/JCO.2004.12.149CrossRefPubMed Barnholtz-Sloan JS, Sloan AE, Davis FG, Vigneau FD, Lai P, Sawaya RE: Incidence proportions of brain metastases in patients diagnosed (1973 to 2001) in the Metropolitan Detroit Cancer Surveillance System. J Clin Oncol 2004, 22:2865–72. 10.1200/JCO.2004.12.149CrossRefPubMed
2.
go back to reference Castrucci WA, Knisely JP: An update on the treatment of CNS metastases in small cell lung cancer. Cancer J 2008, 14:138–46. 10.1097/PPO.0b013e318172d6e1CrossRefPubMed Castrucci WA, Knisely JP: An update on the treatment of CNS metastases in small cell lung cancer. Cancer J 2008, 14:138–46. 10.1097/PPO.0b013e318172d6e1CrossRefPubMed
3.
go back to reference Zimmermann S, Dziadziuszko R, Peters S: Indications and limitations of chemotherapy and targeted agents in non-small cell lung cancer brain metastases. Cancer Treatment Rev 2014, 40:716–22. 10.1016/j.ctrv.2014.03.005CrossRef Zimmermann S, Dziadziuszko R, Peters S: Indications and limitations of chemotherapy and targeted agents in non-small cell lung cancer brain metastases. Cancer Treatment Rev 2014, 40:716–22. 10.1016/j.ctrv.2014.03.005CrossRef
4.
go back to reference Huang H, Held-Feindt J, Buhl R, Mehdorn HM, Mentlein R: Expression of VEGF and its receptors in different brain tumors. Neurol Res 2005, 27:371–7. 10.1179/016164105X39833CrossRefPubMed Huang H, Held-Feindt J, Buhl R, Mehdorn HM, Mentlein R: Expression of VEGF and its receptors in different brain tumors. Neurol Res 2005, 27:371–7. 10.1179/016164105X39833CrossRefPubMed
6.
go back to reference Holash J, Maisonpierre PC, Compton D, Boland P, Alexander CR, Zagzag D, Yancopoulos GD, Wiegand SJ: Vessel cooption, regression, and growth in tumors mediated by angiopoietins and VEGF. Science 1999, 284:1994–8. 10.1126/science.284.5422.1994CrossRefPubMed Holash J, Maisonpierre PC, Compton D, Boland P, Alexander CR, Zagzag D, Yancopoulos GD, Wiegand SJ: Vessel cooption, regression, and growth in tumors mediated by angiopoietins and VEGF. Science 1999, 284:1994–8. 10.1126/science.284.5422.1994CrossRefPubMed
7.
go back to reference Jain RK: Antiangiogenic therapy for cancer: current and emerging concepts. Oncology 2005, 19:7–16.PubMed Jain RK: Antiangiogenic therapy for cancer: current and emerging concepts. Oncology 2005, 19:7–16.PubMed
8.
9.
go back to reference Vredenburgh JJ, Desjardins A, Herndon JE 2nd, Dowell JM, Reardon DA, Quinn JA, Rich JN, Sathornsumetee S, Gururangan S, Wagner M, et al.: Phase II trial of bevacizumab and irinotecan in recurrent malignant glioma. Clin Cancer Res 2007, 13:1253–9. 10.1158/1078-0432.CCR-06-2309CrossRefPubMed Vredenburgh JJ, Desjardins A, Herndon JE 2nd, Dowell JM, Reardon DA, Quinn JA, Rich JN, Sathornsumetee S, Gururangan S, Wagner M, et al.: Phase II trial of bevacizumab and irinotecan in recurrent malignant glioma. Clin Cancer Res 2007, 13:1253–9. 10.1158/1078-0432.CCR-06-2309CrossRefPubMed
10.
go back to reference Gilbert MR, Dignam JJ, Armstrong TS, Wefel JS, Blumenthal DT, Vogelbaum MA, Colman H, Chakravarti A, Pugh S, Won M, et al.: A randomized trial of bevacizumab for newly diagnosed glioblastoma. N Engl J Med 2014, 370:699–708. 10.1056/NEJMoa1308573CrossRefPubMedCentralPubMed Gilbert MR, Dignam JJ, Armstrong TS, Wefel JS, Blumenthal DT, Vogelbaum MA, Colman H, Chakravarti A, Pugh S, Won M, et al.: A randomized trial of bevacizumab for newly diagnosed glioblastoma. N Engl J Med 2014, 370:699–708. 10.1056/NEJMoa1308573CrossRefPubMedCentralPubMed
11.
go back to reference De Braganca KC, Janjigian YY, Azzoli CG, Kris MG, Pietanza MC, Nolan CP, Omuro AM, Holodny AI, Lassman AB: Efficacy and safety of bevacizumab in active brain metastases from non-small cell lung cancer. J Neurooncol 2010, 100:443–7. 10.1007/s11060-010-0200-2CrossRefPubMedCentralPubMed De Braganca KC, Janjigian YY, Azzoli CG, Kris MG, Pietanza MC, Nolan CP, Omuro AM, Holodny AI, Lassman AB: Efficacy and safety of bevacizumab in active brain metastases from non-small cell lung cancer. J Neurooncol 2010, 100:443–7. 10.1007/s11060-010-0200-2CrossRefPubMedCentralPubMed
12.
go back to reference Socinski MA, Langer CJ, Huang JE, Kolb MM, Compton P, Wang L, Akerley W: Safety of bevacizumab in patients with non–small-cell lung cancer and brain metastases. J Clin Oncol 2009, 27:5255–61. 10.1200/JCO.2009.22.0616CrossRefPubMed Socinski MA, Langer CJ, Huang JE, Kolb MM, Compton P, Wang L, Akerley W: Safety of bevacizumab in patients with non–small-cell lung cancer and brain metastases. J Clin Oncol 2009, 27:5255–61. 10.1200/JCO.2009.22.0616CrossRefPubMed
13.
go back to reference Zustovich F, Ferro A, Lombardi G, Zagonel V, Fiduccia P, Farina P: Bevacizumab as front-line treatment of brain metastases from solid tumors: a case series. Anticancer Res 2013, 33:4061–5.PubMed Zustovich F, Ferro A, Lombardi G, Zagonel V, Fiduccia P, Farina P: Bevacizumab as front-line treatment of brain metastases from solid tumors: a case series. Anticancer Res 2013, 33:4061–5.PubMed
14.
go back to reference Pope WB, Young JR, Ellingson BM: Advances in MRI assessment of gliomas and response to anti-VEGF therapy. Curr Neurol Neurosci Rep 2011, 11:336–44. 10.1007/s11910-011-0179-xCrossRefPubMedCentralPubMed Pope WB, Young JR, Ellingson BM: Advances in MRI assessment of gliomas and response to anti-VEGF therapy. Curr Neurol Neurosci Rep 2011, 11:336–44. 10.1007/s11910-011-0179-xCrossRefPubMedCentralPubMed
15.
go back to reference Abbas Z, Gras V, Möllenhoff K, Keil F, Oros-Peusquens AM, Shah NJ: Analysis of proton-density bias corrections based on T1 measurement for robust quantification of water content in the brain at 3 Tesla. Magn Reson Med 2014, 72:1735–45. 10.1002/mrm.25086CrossRefPubMed Abbas Z, Gras V, Möllenhoff K, Keil F, Oros-Peusquens AM, Shah NJ: Analysis of proton-density bias corrections based on T1 measurement for robust quantification of water content in the brain at 3 Tesla. Magn Reson Med 2014, 72:1735–45. 10.1002/mrm.25086CrossRefPubMed
16.
go back to reference Kamman RL, Go KG, Brouwer W, Berendsen HJ: Nuclear magnetic resonance relaxation in experimental brain edema: effects of water concentration, proteinconcentration, and temperature. Magn Reson Med 1988, 6:265–74. 10.1002/mrm.1910060304CrossRefPubMed Kamman RL, Go KG, Brouwer W, Berendsen HJ: Nuclear magnetic resonance relaxation in experimental brain edema: effects of water concentration, proteinconcentration, and temperature. Magn Reson Med 1988, 6:265–74. 10.1002/mrm.1910060304CrossRefPubMed
17.
go back to reference Gahramanov S, Muldoon LL, Li X, Neuwelt EA: Improved perfusion MRI assessment of intracerebral tumor blood volume and antiangiogenic therapy efficacy in a rat model using ferumoxytol. Radiology 2011, 261:796–804. 10.1148/radiol.11103503CrossRefPubMedCentralPubMed Gahramanov S, Muldoon LL, Li X, Neuwelt EA: Improved perfusion MRI assessment of intracerebral tumor blood volume and antiangiogenic therapy efficacy in a rat model using ferumoxytol. Radiology 2011, 261:796–804. 10.1148/radiol.11103503CrossRefPubMedCentralPubMed
18.
go back to reference Hu LS, Baxter LC, Smith KA, Feuerstein BG, Karis JP, Eschbacher JM, Coons SW, Nakaji P, Yeh RF, Debbins J, Heiserman JE: Relative cerebral blood volume values to differentiate high-grade glioma recurrence from posttreatment radiation effect: direct correlation between image-guided tissue histopathology and localized dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging measurements. AJNR Am J Neuroradiol 2009, 30:552–8. 10.3174/ajnr.A1377CrossRefPubMed Hu LS, Baxter LC, Smith KA, Feuerstein BG, Karis JP, Eschbacher JM, Coons SW, Nakaji P, Yeh RF, Debbins J, Heiserman JE: Relative cerebral blood volume values to differentiate high-grade glioma recurrence from posttreatment radiation effect: direct correlation between image-guided tissue histopathology and localized dynamic susceptibility-weighted contrast-enhanced perfusion MR imaging measurements. AJNR Am J Neuroradiol 2009, 30:552–8. 10.3174/ajnr.A1377CrossRefPubMed
19.
go back to reference Li X, Rooney WD, Várallyay CG, Gahramanov S, Muldoon LL, Goodman JA, Tagge IJ, Selzer AH, Pike MM, Neuwelt EA, Springer CSJ: Dynamic-contrast-enhanced-MRI with extravasating contrast reagent: rat cerebral glioma blood volume determination. J Magn Reson 2010, 206:190–9. 10.1016/j.jmr.2010.07.004CrossRefPubMedCentralPubMed Li X, Rooney WD, Várallyay CG, Gahramanov S, Muldoon LL, Goodman JA, Tagge IJ, Selzer AH, Pike MM, Neuwelt EA, Springer CSJ: Dynamic-contrast-enhanced-MRI with extravasating contrast reagent: rat cerebral glioma blood volume determination. J Magn Reson 2010, 206:190–9. 10.1016/j.jmr.2010.07.004CrossRefPubMedCentralPubMed
20.
go back to reference Roberts HC, Roberts TP, Brasch RC, Dillon WP: Quantitative measurement of microvascular permeability in human brain tumors achieved using dynamic contrast-enhanced MR imaging: correlation with histologic grade. AJNR Am J Neuroradiol 2000, 21:891–9.PubMed Roberts HC, Roberts TP, Brasch RC, Dillon WP: Quantitative measurement of microvascular permeability in human brain tumors achieved using dynamic contrast-enhanced MR imaging: correlation with histologic grade. AJNR Am J Neuroradiol 2000, 21:891–9.PubMed
21.
go back to reference Tofts PS, Brix G, Buckley DL, Evelhoch JL, Henderson E, Knopp MV, Larsson HB, Lee TY, Mayr NA, Parker GJ, et al.: Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging 1999, 10:223–32. 10.1002/(SICI)1522-2586(199909)10:3<223::AID-JMRI2>3.0.CO;2-SCrossRefPubMed Tofts PS, Brix G, Buckley DL, Evelhoch JL, Henderson E, Knopp MV, Larsson HB, Lee TY, Mayr NA, Parker GJ, et al.: Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging 1999, 10:223–32. 10.1002/(SICI)1522-2586(199909)10:3<223::AID-JMRI2>3.0.CO;2-SCrossRefPubMed
22.
go back to reference Thompson EM, Frenkel EP, Neuwelt EA: The paradoxical effect of bevacizumab in the therapy of malignant gliomas. Neurology 2011, 76:87–93. 10.1212/WNL.0b013e318204a3afCrossRefPubMedCentralPubMed Thompson EM, Frenkel EP, Neuwelt EA: The paradoxical effect of bevacizumab in the therapy of malignant gliomas. Neurology 2011, 76:87–93. 10.1212/WNL.0b013e318204a3afCrossRefPubMedCentralPubMed
23.
go back to reference Varallyay CG, Nesbit E, Fu R, Gahramanov S, Moloney B, Earl E, Muldoon LL, Li X, Rooney WD, Neuwelt EA: High-resolution steady-state cerebral blood volume maps in patients with central nervous system neoplasms using ferumoxytol, a superparamagnetic iron oxide nanoparticle. J Cereb Blood Flow Metab 2013, 33:780–6. 10.1038/jcbfm.2013.36CrossRefPubMedCentralPubMed Varallyay CG, Nesbit E, Fu R, Gahramanov S, Moloney B, Earl E, Muldoon LL, Li X, Rooney WD, Neuwelt EA: High-resolution steady-state cerebral blood volume maps in patients with central nervous system neoplasms using ferumoxytol, a superparamagnetic iron oxide nanoparticle. J Cereb Blood Flow Metab 2013, 33:780–6. 10.1038/jcbfm.2013.36CrossRefPubMedCentralPubMed
24.
go back to reference Fine HA: Bevacizumab in glioblastoma–still much to learn. N Engl J Med 2014, 370:764–5. 10.1056/NEJMe1313309CrossRefPubMed Fine HA: Bevacizumab in glioblastoma–still much to learn. N Engl J Med 2014, 370:764–5. 10.1056/NEJMe1313309CrossRefPubMed
26.
go back to reference Fokas E, Steinbach JP, Rodel C: Biology of brain metastases and novel targeted therapies: time to translate the research. Biochim Biophys Acta 1835, 2013:61–75. Fokas E, Steinbach JP, Rodel C: Biology of brain metastases and novel targeted therapies: time to translate the research. Biochim Biophys Acta 1835, 2013:61–75.
27.
go back to reference Kodack DP, Chung E, Yamashita H, Incio J, Duyverman AM, Song Y, Farrar CT, Huang Y, Ager E, Kamoun W, et al.: Combined targeting of HER2 and VEGFR2 for effective treatment of HER2-amplified breast cancer brain metastases. Proc Natl Acad Sci U S A 2012, 109:E3119–3127. 10.1073/pnas.1216078109CrossRefPubMedCentralPubMed Kodack DP, Chung E, Yamashita H, Incio J, Duyverman AM, Song Y, Farrar CT, Huang Y, Ager E, Kamoun W, et al.: Combined targeting of HER2 and VEGFR2 for effective treatment of HER2-amplified breast cancer brain metastases. Proc Natl Acad Sci U S A 2012, 109:E3119–3127. 10.1073/pnas.1216078109CrossRefPubMedCentralPubMed
28.
go back to reference Muldoon LL, Gahramanov S, Li X, Marshall DJ, Kraemer DF, Neuwelt EA: Dynamic magnetic resonance imaging assessment of vascular targeting agent effects in rat intracerebral tumor models. Neuro Oncol 2011, 13:51–60. 10.1093/neuonc/noq150CrossRefPubMedCentralPubMed Muldoon LL, Gahramanov S, Li X, Marshall DJ, Kraemer DF, Neuwelt EA: Dynamic magnetic resonance imaging assessment of vascular targeting agent effects in rat intracerebral tumor models. Neuro Oncol 2011, 13:51–60. 10.1093/neuonc/noq150CrossRefPubMedCentralPubMed
29.
go back to reference JuanYin J, Tracy K, Zhang L, Munasinghe J, Shapiro E, Koretsky A, Kelly K: Noninvasive imaging of the functional effects of anti-VEGF therapy on tumor cell extravasation and regional blood volume in an experimental brain metastasis model. Clin Exp Metastasis 2009, 26:403–414. 10.1007/s10585-009-9238-yCrossRefPubMed JuanYin J, Tracy K, Zhang L, Munasinghe J, Shapiro E, Koretsky A, Kelly K: Noninvasive imaging of the functional effects of anti-VEGF therapy on tumor cell extravasation and regional blood volume in an experimental brain metastasis model. Clin Exp Metastasis 2009, 26:403–414. 10.1007/s10585-009-9238-yCrossRefPubMed
30.
go back to reference Varallyay CG, Muldoon LL, Gahramanov S, Wu YJ, Goodman JA, Li X, Pike MM, Neuwelt EA: Dynamic MRI using iron oxide nanoparticles to assess early vascular effects of antiangiogenic versus corticosteroid treatment in a glioma model. J Cereb Blood Flow Metab 2009, 29:853–60. 10.1038/jcbfm.2008.162CrossRefPubMedCentralPubMed Varallyay CG, Muldoon LL, Gahramanov S, Wu YJ, Goodman JA, Li X, Pike MM, Neuwelt EA: Dynamic MRI using iron oxide nanoparticles to assess early vascular effects of antiangiogenic versus corticosteroid treatment in a glioma model. J Cereb Blood Flow Metab 2009, 29:853–60. 10.1038/jcbfm.2008.162CrossRefPubMedCentralPubMed
31.
go back to reference Vecht CJ, Hovestadt A, Verbiest HB, van Vliet JJ, van Putten WL: Dose-effect relationship of dexamethasone on Karnofsky performance in metastatic brain tumors: a randomized study of doses of 4, 8, and 16 mg per day. Neurology 1994, 44:675–80. 10.1212/WNL.44.4.675CrossRefPubMed Vecht CJ, Hovestadt A, Verbiest HB, van Vliet JJ, van Putten WL: Dose-effect relationship of dexamethasone on Karnofsky performance in metastatic brain tumors: a randomized study of doses of 4, 8, and 16 mg per day. Neurology 1994, 44:675–80. 10.1212/WNL.44.4.675CrossRefPubMed
32.
go back to reference McSheehy PMJ, Weidensteiner C, Cannet C, Ferretti S, Laurent D, Ruetz S, Stumm M, Allegrini PR: Quantified tumor t1 is a generic early-response imaging biomarker for chemotherapy reflecting cell viability. Clin Cancer Res 2010, 16:212–25. 10.1158/1078-0432.CCR-09-0686CrossRefPubMed McSheehy PMJ, Weidensteiner C, Cannet C, Ferretti S, Laurent D, Ruetz S, Stumm M, Allegrini PR: Quantified tumor t1 is a generic early-response imaging biomarker for chemotherapy reflecting cell viability. Clin Cancer Res 2010, 16:212–25. 10.1158/1078-0432.CCR-09-0686CrossRefPubMed
33.
go back to reference Jokivarsi KT, Niskanen JP, Michaeli S, Gröhn HI, Garwood M, Kauppinen RA, Gröhn OH: Quantitative assessment of water pools by T 1 rho and T 2 rho MRI in acute cerebral ischemia of the rat. J Cereb Blood Flow Metab 2009, 29:206–16. 10.1038/jcbfm.2008.113CrossRefPubMed Jokivarsi KT, Niskanen JP, Michaeli S, Gröhn HI, Garwood M, Kauppinen RA, Gröhn OH: Quantitative assessment of water pools by T 1 rho and T 2 rho MRI in acute cerebral ischemia of the rat. J Cereb Blood Flow Metab 2009, 29:206–16. 10.1038/jcbfm.2008.113CrossRefPubMed
34.
go back to reference Tong RT, Boucher Y, Kozin SV, Winkler F, Hicklin DJ, Jain RK: Vascular normalization by vascular endothelial growth factor receptor 2 blockade induces a pressure gradient across the vasculature and improves drug penetration in tumors. Cancer Res 2004, 64:3731–6. 10.1158/0008-5472.CAN-04-0074CrossRefPubMed Tong RT, Boucher Y, Kozin SV, Winkler F, Hicklin DJ, Jain RK: Vascular normalization by vascular endothelial growth factor receptor 2 blockade induces a pressure gradient across the vasculature and improves drug penetration in tumors. Cancer Res 2004, 64:3731–6. 10.1158/0008-5472.CAN-04-0074CrossRefPubMed
35.
go back to reference Kienast Y, von Baumgarten L, Fuhrmann M, Klinker WEF, Goldbrunner R, Herms J, Winkler F: Real-time imaging reveals the single steps of brain metastasis formation. Nature Med 2010, 16:116–23. 10.1038/nm.2072CrossRefPubMed Kienast Y, von Baumgarten L, Fuhrmann M, Klinker WEF, Goldbrunner R, Herms J, Winkler F: Real-time imaging reveals the single steps of brain metastasis formation. Nature Med 2010, 16:116–23. 10.1038/nm.2072CrossRefPubMed
36.
go back to reference Lockman PR, Mittapalli RK, Taskar KS, Rudraraju V, Gril B, Bohn KA, Adkins CE, Roberts A, Thorsheim HR, Gaasch JA, et al.: Heterogeneous blood–tumor barrier permeability determines drug efficacy in experimental brain metastases of breast cancer. Clin Cancer Res 2010, 16:5664–78. 10.1158/1078-0432.CCR-10-1564CrossRefPubMedCentralPubMed Lockman PR, Mittapalli RK, Taskar KS, Rudraraju V, Gril B, Bohn KA, Adkins CE, Roberts A, Thorsheim HR, Gaasch JA, et al.: Heterogeneous blood–tumor barrier permeability determines drug efficacy in experimental brain metastases of breast cancer. Clin Cancer Res 2010, 16:5664–78. 10.1158/1078-0432.CCR-10-1564CrossRefPubMedCentralPubMed
37.
go back to reference Claes A, Wesseling P, Jeuken J, Maass C, Heerschap A, Leenders WP: Antiangiogenic compounds interfere with chemotherapy of brain tumors due to vessel normalization. Mol Cancer Ther 2008, 7:71–8.CrossRefPubMed Claes A, Wesseling P, Jeuken J, Maass C, Heerschap A, Leenders WP: Antiangiogenic compounds interfere with chemotherapy of brain tumors due to vessel normalization. Mol Cancer Ther 2008, 7:71–8.CrossRefPubMed
38.
go back to reference Brandsma D, van den Bent MJ: Pseudoprogression and pseudoresponse in the treatment of gliomas. Curr Opin Neurol 2009, 22:633–8. 10.1097/WCO.0b013e328332363eCrossRefPubMed Brandsma D, van den Bent MJ: Pseudoprogression and pseudoresponse in the treatment of gliomas. Curr Opin Neurol 2009, 22:633–8. 10.1097/WCO.0b013e328332363eCrossRefPubMed
Metadata
Title
Vascular endothelial growth factor blockade alters magnetic resonance imaging biomarkers of vascular function and decreases barrier permeability in a rat model of lung cancer brain metastasis
Authors
Gregory L Pishko
Leslie L Muldoon
Michael A Pagel
Daniel L Schwartz
Edward A Neuwelt
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Fluids and Barriers of the CNS / Issue 1/2015
Electronic ISSN: 2045-8118
DOI
https://doi.org/10.1186/2045-8118-12-5

Other articles of this Issue 1/2015

Fluids and Barriers of the CNS 1/2015 Go to the issue