Metabolic response of glioblastoma to superselective intra-arterial cerebral infusion of bevacizumab: a proton MR spectroscopic imaging study.

TitleMetabolic response of glioblastoma to superselective intra-arterial cerebral infusion of bevacizumab: a proton MR spectroscopic imaging study.
Publication TypeJournal Article
Year of Publication2012
AuthorsJeon JY, Kovanlikaya I, Boockvar JA, Mao X, Shin B, Burkhardt JK, Kesavabhotla K, Christos P, Riina H, Shungu DC, Tsiouris AJ
JournalAJNR Am J Neuroradiol
Volume33
Issue11
Pagination2095-102
Date Published2012 Dec
ISSN1936-959X
KeywordsAged, Angiogenesis Inhibitors, Antibodies, Monoclonal, Humanized, Aspartic Acid, Bevacizumab, Brain, Brain Neoplasms, Cerebral Arteries, Choline, Female, Glioblastoma, Humans, Infusions, Intra-Arterial, Magnetic Resonance Spectroscopy, Male, Middle Aged, Protons, Treatment Outcome
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.

DOI10.3174/ajnr.A3091
Alternate JournalAJNR Am J Neuroradiol
PubMed ID22576886
PubMed Central IDPMC7965590
Grant ListK08 CA130985 / CA / NCI NIH HHS / United States
UL1 RR024996 / RR / NCRR NIH HHS / United States
CA130985 / CA / NCI NIH HHS / United States
RR024996 / RR / NCRR NIH HHS / United States
Related Institute: 
MRI Research Institute (MRIRI)

Weill Cornell Medicine
Department of Radiology
525 East 68th Street New York, NY 10065