Advances in MRI assessment of gliomas and response to anti-VEGF therapy.
Advances in MRI assessment of gliomas and response to anti-VEGF therapy.
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DOI：
10.1007/s11910-011-0179-x
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发表时间：
2011-06
影响因子：
5.6
通讯作者：
Ellingson, Benjamin M.
中科院分区：
文献类型：
--
作者：
Pope, Whitney B.;Young, Jonathan R.;Ellingson, Benjamin M.
关键词：
贝伐单抗被认为可以使肿瘤血管正常化，恢复血脑屏障，减少强化和瘤周水肿。肿瘤反应的常规测量依赖于增强肿瘤的维度。在贝伐单抗治疗后，胶质母细胞瘤更容易进展为无强化的肿瘤。神经肿瘤学的反应评估(RANO)标准使用液体衰减反转恢复(FLAIR)/T2高信号替代无强化的肿瘤；然而，无强化的肿瘤很难与其他引起FLAIR/T2高信号的原因(如辐射诱导的胶质增生症)相鉴别。由于这些困难，最近的努力被用于识别新的生物标记物，这些标记物既可以预测治疗反应，也可以在治疗开始后不久准确测量增强和非增强肿瘤的反应。这将使患者能够更早地做出治疗决定，使患者免受无效治疗的不利影响，同时允许他们更早地尝试替代疗法。一个活跃的研究领域是使用生理成像，它可以在肿瘤大小变化明显之前潜在地检测治疗效果。
Bevacizumab is thought to normalize tumor vasculature and restore the blood–brain barrier, decreasing enhancement and peritumoral edema. Conventional measurements of tumor response rely upon dimensions of enhancing tumor. After bevacizumab treatment, glioblastomas are more prone to progress as nonenhancing tumor. The RANO (Response Assessment in Neuro-Oncology) criteria for glioma response use fluid-attenuated inversion recovery (FLAIR)/T2 hyperintensity as a surrogate for nonenhancing tumor; however, nonenhancing tumor can be difficult to differentiate from other causes of FLAIR/T2 hyperintensity (eg, radiation-induced gliosis). Due to these difficulties, recent efforts have been directed toward identifying new biomarkers that either predict treatment response or accurately measure response of both enhancing and nonenhancing tumor shortly after treatment initiation. This will allow for earlier treatment decisions, saving patients from the adverse effects of ineffective therapies while allowing them to try alternative therapies sooner. An active area of research is the use of physiologic imaging, which can potentially detect treatment effects before changes in tumor size are evident.
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影响因子：
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