Abstract
Purposes: Anti-edema effect of bevacizumab was evaluated using the apparent diffusion coefficient (ADC) of peritumoral edema associated with regional cerebral blood flow (rCBV) of the tumor.
Materials and Methods: Nine patients with recurrent glioblastoma were treated using bevacizumab for 4 ∼ 36 months (average 12 months). MRI was performed every 2 months. For each MRI, ADC value, Gd-enhanced area on T1 imaging, area of peritumoral edema on T2 imaging, and rCBV on perfusion imaging were measured. ADC and rCBV values were determined by the use of regions of interest positioned in areas of high signal intensity, as seen on T2-weighted images and ADC maps.
Results: After 2 months of bevacizumab treatment, ADC values and rCBV decreased 49 and 32 % respectively, associated with marked diminishment of the Gd-enhanced area compared with pretreatment. After 6 months, in 5 of the 9 cases, the Gd-enhanced area appeared again with no change in the ADC value and rCBV. In the other four cases, the Gd-enhanced area as well as the ADC value and rCBV returned to the initial status.
Conclusion: The anti-edema effect of bevacizumab for treatment of recurrent glioblastoma that was demonstrated by decreased ADC values and rCBV was dramatic and Âprolonged at 6 months even with tumor progression.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ananthnarayan S, Bahng J, Roring J, Nghiemphu P, Lai A, Cloughesy T, Pope WB (2008) Time course of imaging changes of GBM during extended bevacizumab treatment. J Neurooncol 88:339–347
Bisdas S, Kirkpatrick M, Giqlio P, Welsh C, Spampinato MV, Rumboldt Z (2009) Cerebral blood volume measurements by Âperfusion-weighted MR imaging in gliomas: ready for prime time in predicting short-term outcome and recurrent disease? AJNR Am J Neuroradiol 30:681–688
Ellingson BM, Malkin MG, Rand SD, Connelly JM, Quinsey C, LaViolette PS, Bedekar DP, Schmainda KM (2010) Validation of functional diffusion maps (fDMs) as a biomarker for human glioma cellularity. J Magn Reson Imaging 31:538–548
Guzman R, Altrichter S, El-Koussy M, Gralla J, Weis J, Barth A, Seiler RW, Schroth G, Lovblad KO (2008) Contribution of the apparent diffusion coefficient in perilesional edema for the assessment of brain tumors. J Neuroradiol 35:224–229
Higano S, Yun X, Kumabe T, Watanabe M, Mujikawa S, Umetsu A, Saito A, Yamada T, Takahashi S (2006) Malignant atsrocytic tumors: clinical importance of apparent diffusion coefficient in production of grade and progression. Radiology 241:839–846
Jain R, Scarpace LM, Ellika S, Torcuator R, Schultz LR, Hearshen D, Mikkelsen T (2010) Imaging response criteria for recurrent gliomas treated with bevacizumab: role of diffusion weighted Âimaging as an imaging biomarker. J Neurooncol 96:423–431
Pope WB, Lai A, Mehta R, Kim HJ, Qiao J, Young JR, Xue X, Goldin J, Brown MS, Nghiemphu PL, Tran A, Cloughesy TF (2011) Apparent diffusion coefficient histogram analysis stratifies progression-free survival in newly diagnosed bevacizumab-treated Âglioblastoma. AJNR Am J Neuroradiol 32:882–889
Conflict of Interest
We declare that we have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer-Verlag Wien
About this paper
Cite this paper
Takano, S. et al. (2013). Decrease in the Apparent Diffusion Coefficient in Peritumoral Edema for the Assessment of Recurrent Glioblastoma Treated by Bevacizumab. In: Katayama, Y., Maeda, T., Kuroiwa, T. (eds) Brain Edema XV. Acta Neurochirurgica Supplement, vol 118. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1434-6_34
Download citation
DOI: https://doi.org/10.1007/978-3-7091-1434-6_34
Published:
Publisher Name: Springer, Vienna
Print ISBN: 978-3-7091-1433-9
Online ISBN: 978-3-7091-1434-6
eBook Packages: MedicineMedicine (R0)