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Journal of Neuro-Oncology

, Volume 96, Issue 3, pp 423–431 | Cite as

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

  • Rajan Jain
  • Lisa M. Scarpace
  • Shehanaz Ellika
  • Roy Torcuator
  • Lonni R. Schultz
  • David Hearshen
  • Tom Mikkelsen
Clinical Study - Patient Study

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.

Keywords

Diffusion ADC Avastin Bevacizumab Recurrent glioma 

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Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Rajan Jain
    • 1
  • Lisa M. Scarpace
    • 1
  • Shehanaz Ellika
    • 1
  • Roy Torcuator
    • 1
  • Lonni R. Schultz
    • 1
  • David Hearshen
    • 1
  • Tom Mikkelsen
    • 1
  1. 1.Henry Ford HospitalDetroitUSA

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