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Quantification of edema reduction using differential quantitative T2 (DQT2) relaxometry mapping in recurrent glioblastoma treated with bevacizumab

  • Clinical Study – Patient Study
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Abstract

The purpose of the current study was to quantify the reduction in T2 signal abnormality accompanying administration of the anti-angiogenic drug bevacizumab in recurrent glioblastoma (GBM) patients using a voxel-wise differential quantitative T2 (DQT2) mapping technique. Twenty-six patients with recurrent GBM treated with bevacizumab were scanned before and 4–6 weeks after treatment on a 1.5T clinical MR scanner. Quantitative T2 maps were created from proton density and T2-weighted images acquired using a standard multi-echo fast-spin echo sequence. T2 maps after treatment were co-registered with T2 maps prior to treatment in the same patient, and then voxel-wise subtraction was performed to create DQT2 maps for each patient. Results suggest DQT2 maps allow visualization and quantification of voxel-wise T2 changes resulting from anti-VEGF therapy. Results demonstrated a significant decrease in T2 within pre-treatment T2 abnormal regions (mean reduction = 49.4 ms at 1.5T) following anti-VEGF treatment (Wilcoxon signed rank test, P < 0.0001). An elevated residual, post-treatment, median T2 was predictive of both progression-free (Log-rank, P = 0.0074) and overall survival (Log-rank, P = 0.0393).

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Acknowledgment

This study was supported by grants from Brain Tumor Funders Collaborative (WBP); Art of the Brain (TFC); Ziering Family Foundation in memory of Sigi Ziering (TFC); Singleton Family Foundation (TFC); and Clarence Klein Fund for Neuro-Oncology (TFC).

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Authors and Affiliations

  1. Department of Radiological Sciences, David Geffen School of Medicine, University of California Los Angeles, 924 Westwood Blvd., Suite 650, Los Angeles, CA, 90095, USA

    Benjamin M. Ellingson, Taryar Zaw, Kourosh Motevalibashinaeini & Whitney B. Pope

  2. Department of Biomedical Physics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Benjamin M. Ellingson

  3. Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Timothy F. Cloughesy, Albert Lai, Phioanh L. Nghiemphu & Shadi Lalezari

  4. Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA

    Paul S. Mischel

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  1. Benjamin M. Ellingson
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Correspondence to Benjamin M. Ellingson.

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Ellingson, B.M., Cloughesy, T.F., Lai, A. et al. Quantification of edema reduction using differential quantitative T2 (DQT2) relaxometry mapping in recurrent glioblastoma treated with bevacizumab. J Neurooncol 106, 111–119 (2012). https://doi.org/10.1007/s11060-011-0638-x

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  • DOI: https://doi.org/10.1007/s11060-011-0638-x

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