Decrease in the apparent diffusion coefficient in peritumoral edema for the assessment of recurrent glioblastoma treated by bevacizumab.
Decrease in the apparent diffusion coefficient in peritumoral edema for the assessment of recurrent glioblastoma treated by bevacizumab.
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DOI：
10.1007/978-3-7091-1434-6_34
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发表时间：
2013-01-01
期刊：
影响因子：
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通讯作者：
Matsumura, Akira
中科院分区：
文献类型：
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作者：
Takano, Shingo;Kimu, Hidehiro;Matsumura, Akira
医生：贝伐单抗的抗水肿作用进行了评估，使用表观扩散系数（ADC）与区域脑血流量（rCBV）的肿瘤。材料和方法：9例复发性胶质母细胞瘤用贝伐单抗治疗4 - 36个月（平均12个月）。每2个月进行一次MRI检查。测量每个MRI的ADC值、T1成像上的Gd增强面积、T2成像上的瘤周水肿面积和灌注成像上的rCBV。ADC和rCBV值通过使用位于高信号强度区域的感兴趣区域来确定，如T2加权图像和ADC map.RESULTS：贝伐单抗治疗2个月后，ADC值和rCBV分别下降49%和32%，与治疗前相比，Gd增强区域明显减少。6个月后，5例再次出现Gd强化区，ADC值和rCBV无变化。在其他4例中，Gd增强区以及ADC值和rCBV恢复到初始状态。结论：贝伐单抗治疗复发性胶质母细胞瘤的抗水肿作用，表现为ADC值和rCBV下降，在6个月时，即使肿瘤进展，仍显着和延长。
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 -prolonged at 6 months even with tumor progression.