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Metabolic Response of Glioblastoma to Superselective Intra-Arterial Cerebral Infusion of Bevacizumab: A Proton Magnetic Resonance Spectroscopic Imaging Study.


Posted on: 05/16/2012

AJNR Am J Neuroradiol. 2012 May 10. [Epub ahead of print]


Metabolic Response of Glioblastoma to Superselective Intra-Arterial Cerebral Infusion of Bevacizumab: A Proton Magnetic Resonance Spectroscopic Imaging Study.

Jeon JY, Kovanlikaya I, Boockvar JA, Mao X, Shin B, Burkhardt JK, Kesavabhotla K, Christos P, Riina H, Shungu DC, Tsiouris AJ.
Source
Departments of Neuroradiology and Neurosurgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, New York; Citigroup Biomedical Imaging Center and Department of Biostatistics and Epidemiology, Weill Cornell Medical College, New York, New York; and Department of Neurosurgery, New York University Medical Center, New York, New York.

Abstract
BACKGROUND AND PURPOSE:
SIACI of bevacizumab has emerged as a promising novel therapy in the treatment of recurrent GB. This study assessed the potential of (1)H-MRS as an adjunctive technique in detecting metabolic changes reflective of antiproliferative effects of targeted infusion of bevacizumab in the treatment of GB.

MATERIALS AND METHODS:
Eighteen patients enrolled in a phase I/II study of SIACI of bevacizumab for treatment of recurrent GB were included. Concurrent MR imaging and (1)H-MRS scans were performed before and after treatment. Five distinct morphologic ROIs were evaluated for structural and metabolic changes on MR imaging and (1)H-MRS, which included enhancing, nonenhancing T2 hyperintense signal abnormality, and multiple control regions. Pre- and post-SIACI of bevacizumab peak areas for NAA, tCho, tCr, as well as tCho/tCr and tCho/NAA ratios, were derived for all 5 ROIs and compared using the Wilcoxon signed-rank test.

RESULTS:
A significant median decrease of 25.99% (range -55.76 to 123.94; P = .006) in tCho/NAA was found post-SIACI of bevacizumab relative to pretreatment values in regions of enhancing disease. A trend-level significant median decrease of 6.45% (range -23.71 to 37.67; P = .06) was noted in tCho/NAA posttreatment in regions of nonenhancing T2-hyperintense signal abnormality.

CONCLUSIONS:
The results of this (1)H-MRS analysis suggest that GB treatment with SIACI of bevacizumab may be associated with a direct antiproliferative effect, as demonstrated by significant reductions of tCho/NAA after the intervention.

PMID: 22576886 [PubMed - as supplied by publisher]
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