Current standards and new concepts in MRI and PET response assessment of antiangiogenic therapies in high-grade glioma patients
Current standards and new concepts in MRI and PET response assessment of antiangiogenic therapies in high-grade glioma patients
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DOI：
10.1093/neuonc/nou322
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发表时间：
2015-06-01
期刊：
影响因子：
15.9
通讯作者：
Hau, Peter
中科院分区：
文献类型：
--
作者：
Hutterer, Markus;Hattingen, Elke;Hau, Peter
尽管多模式治疗，高级别胶质瘤的预后是严峻的。由于肿瘤生长严重依赖于新血管形成，抗血管生成治疗方法提供了一种创新的治疗策略。贝伐单抗是一种人源化单克隆抗体，多年来一直是抗血管生成方法的焦点。目前，常规使用MRI（包括对比增强T1加权和T2/液体衰减反转恢复（FLAIR）图像）评价抗血管生成治疗反应（神经肿瘤学反应评估标准）。然而，通过恢复血脑屏障，贝伐珠单抗可能降低T1对比增强和T2/FLAIR高信号，从而模糊了基于成像的进展检测。本综述的目的是强调MR和PET成像中的成像生物标志物在测量疾病进展和抗血管生成治疗有效性方面的最新作用。基于回顾的研究，多模式成像结合标准MRI与新的生理MRI技术和代谢PET成像，特别是氨基酸示踪剂，可能有能力检测抗血管生成药物的敏感性或耐药性之前的形态变化。随着靶向特定生物化学或分子途径并以潜在可预测的方式改变肿瘤生理学的治疗方法的发展，生理和代谢成像生物标志物的验证在不久的将来将变得越来越重要。
Despite multimodal treatment, the prognosis of high-grade gliomas is grim. As tumor growth is critically dependent on new blood vessel formation, antiangiogenic treatment approaches offer an innovative treatment strategy. Bevacizumab, a humanized monoclonal antibody, has been in the spotlight of antiangiogenic approaches for several years. Currently, MRI including contrast-enhanced T1-weighted and T2/fluid-attenuated inversion recovery (FLAIR) images is routinely used to evaluate antiangiogenic treatment response (Response Assessment in Neuro-Oncology criteria). However, by restoring the blood-brain barrier, bevacizumab may reduce T1 contrast enhancement and T2/FLAIR hyperintensity, thereby obscuring the imaging-based detection of progression. The aim of this review is to highlight the recent role of imaging biomarkers from MR and PET imaging on measurement of disease progression and treatment effectiveness in antiangiogenic therapies. Based on the reviewed studies, multimodal imaging combining standard MRI with new physiological MRI techniques and metabolic PET imaging, in particular amino acid tracers, may have the ability to detect antiangiogenic drug susceptibility or resistance prior to morphological changes. As advances occur in the development of therapies that target specific biochemical or molecular pathways and alter tumor physiology in potentially predictable ways, the validation of physiological and metabolic imaging biomarkers will become increasingly important in the near future.