Title | Metabolic response of glioblastoma to superselective intra-arterial cerebral infusion of bevacizumab: a proton MR spectroscopic imaging study. |
Publication Type | Journal Article |
Year of Publication | 2012 |
Authors | Jeon JY, Kovanlikaya I, Boockvar JA, Mao X, Shin B, Burkhardt JK, Kesavabhotla K, Christos P, Riina H, Shungu DC, Tsiouris AJ |
Journal | AJNR Am J Neuroradiol |
Volume | 33 |
Issue | 11 |
Pagination | 2095-102 |
Date Published | 2012 Dec |
ISSN | 1936-959X |
Keywords | Aged, 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. |
DOI | 10.3174/ajnr.A3091 |
Alternate Journal | AJNR Am J Neuroradiol |
PubMed ID | 22576886 |
PubMed Central ID | PMC7965590 |
Grant List | K08 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)