Metabolic response of glioblastoma to superselective intra-arterial cerebral infusion of bevacizumab: a proton MR spectroscopic imaging study.
| Publication Type | Academic Article |
| Authors | Jeon J, Kovanlikaya I, Boockvar J, Mao X, Shin B, K Burkhardt J, Kesavabhotla K, Christos P, Riina H, Shungu D, Tsiouris A |
| Journal | AJNR Am J Neuroradiol |
| Volume | 33 |
| Issue | 11 |
| Pagination | 2095-102 |
| Date Published | 05/10/2012 |
| ISSN | 1936-959X |
| Keywords | Antibodies, Monoclonal, Humanized, Brain Neoplasms, Glioblastoma, Magnetic Resonance Spectroscopy |
| 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 |
| PubMed ID | 22576886 |
| PubMed Central ID | PMC7965590 |