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Forschungsdatenbank PMU-SQQUID

ADC histograms predict response to anti-angiogenic therapy in patients with recurrent high-grade glioma.
Nowosielski, M; Recheis, W; Goebel, G; Güler, O; Tinkhauser, G; Kostron, H; Schocke, M; Gotwald, T; Stockhammer, G; Hutterer, M;
NEURORADIOLOGY. 2011; 53(4): 291-302.
Originalarbeiten (Zeitschrift)

PMU-Autor/inn/en


Abstract

The purpose of this study is to evaluate apparent diffusion coefficient (ADC) maps to distinguish anti-vascular and anti-tumor effects in the course of anti-angiogenic treatment of recurrent high-grade gliomas (rHGG) as compared to standard magnetic resonance imaging (MRI). This retrospective study analyzed ADC maps from diffusion-weighted MRI in 14 rHGG patients during bevacizumab/irinotecan (B/I) therapy. Applying image segmentation, volumes of contrast-enhanced lesions in T1 sequences and of hyperintense T2 lesions (hT2) were calculated. hT2 were defined as regions of interest (ROI) and registered to corresponding ADC maps (hT2-ADC). Histograms were calculated from hT2-ADC ROIs. Thereafter, histogram asymmetry termed "skewness" was calculated and compared to progression-free survival (PFS) as defined by the Response Assessment Neuro-Oncology (RANO) Working Group criteria. At 8-12 weeks follow-up, seven (50%) patients showed a partial response, three (21.4%) patients were stable, and four (28.6%) patients progressed according to RANO criteria. hT2-ADC histograms demonstrated statistically significant changes in skewness in relation to PFS at 6 months. Patients with increasing skewness (n = 11) following B/I therapy had significantly shorter PFS than did patients with decreasing or stable skewness values (n = 3, median percentage change in skewness 54% versus -3%, p = 0.04). In rHGG patients, the change in ADC histogram skewness may be predictive for treatment response early in the course of anti-angiogenic therapy and more sensitive than treatment assessment based solely on RANO criteria.


Useful keywords (using NLM MeSH Indexing)

Adult

Aged

Angiogenesis Inhibitors/administration*

dosage

Antibodies, Monoclonal/administration*

dosage

Antibodies, Monoclonal, Humanized

Antineoplastic Agents, Phytogenic/administration*

dosage

Antineoplastic Combined Chemotherapy Protocols

Brain Neoplasms/drug therapy

Brain Neoplasms/pathology*

Camptothecin/administration*

dosage

Camptothecin/analogs*

derivatives

Diffusion Magnetic Resonance Imaging/methods*

Female

Follow-Up Studies

Glioma/drug therapy

Glioma/pathology*

Humans

Male

Middle Aged

Prognosis

Recurrence

Retrospective Studies

Treatment Outcome


Find related publications in this database (Keywords)

Recurrent high-grade glioma
Anti-angiogenic therapy
DWI-MRI
ADC histograms
Skewness