P16.19 * THE EFFECTS OF BEVACIZUMAB ON MR-IMAGING AND 1H-MR-SPECTROSCOPY (MRS) IN PATIENTS WITH HIGH GRADE GLIOMAS

Object. It is standard practice for the oncological follow-up of patients with brain tumors (especially in the setting of clinical trials) to include neurological examination and neuroradiological studies such as computerized tomography (CT) or magnetic resonance (MR) imaging in addition to evaluation of the patients' symptomatology and performance score. The validity of this practice and its impact on the welfare of patients with high-grade gliomas has not been adequately assessed. The purpose of this study is to provide such an assessment.Methods. The authors studied 231 similarly treated patients who were participating in three prospective North Central Cancer Treatment Group or Mayo Clinic trials who developed progressive disease during follow up. According to the protocol, the symptom status, performance score, results of neurological examination, and CT or MR status were recorded prospectively in each patient at each evaluation (every 6–8 weeks).At progression, 177 (77%) of 231 patients experienced worsening of their baseline symptoms or they developed new ones. In the remaining 54 asymptomatic patients (23%), neuroradiological imaging revealed the progression. Asymptomatic progression was more likely to be detected on MR imaging compared with CT studies (p < 0.01). In no asymptomatic patient was progression detected on neurological examination alone. The median survival time after tumor recurrence was 13.3 weeks in symptomatic patients compared with 41.7 weeks in the asymptomatic group (p < 0.0001). Asymptomatic patients were more aggressively treated, with surgery (p < 0.0001) and second-line chemotherapy (p < 0.0002). Multivariate analysis of survival time following first progression by using both classification and regression trees and Cox models showed that treatment at recurrence was the most important prognostic variable.Conclusions. Symptoms are the most frequent indicators of progression in patients with high-grade gliomas (77%). All asymptomatic progressions were detected on neuroradiological studies; MR imaging was more likely than CT scanning to reveal asymptomatic recurrences. Survival after disease progression was significantly longer in asymptomatic patients and could be related both to treatment following progression and to other favorable prognostic factors such as performance score.

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High-Grade Gliomas and Solitary Metastases: Differentiation by Using Perfusion and Proton Spectroscopic MR Imaging

Radiology ◽

10.1148/radiol.2223010558 ◽

2002 ◽

Vol 222 (3) ◽

pp. 715-721 ◽

Cited By ~ 367

Author(s):

Meng Law ◽

Soonmee Cha ◽

Edmond A. Knopp ◽

Glyn Johnson ◽

John Arnett ◽

...

Keyword(s):

Mr Imaging ◽

High Grade ◽

High Grade Gliomas ◽

Solitary Metastases

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Serial MR imaging and 1H-MR spectroscopy of unidentified bright objects in a case of neurofibromatosis type 1

Brain and Development ◽

10.1016/j.braindev.2005.02.008 ◽

2005 ◽

Vol 27 (8) ◽

pp. 595-597 ◽

Cited By ~ 8

Author(s):

Atsushi Imamura ◽

Naoki Matsuo ◽

Miho Okuda ◽

Hideyuki Morita ◽

Masako Iwata ◽

...

Keyword(s):

Mr Imaging ◽

Neurofibromatosis Type 1 ◽

Mr Spectroscopy ◽

Neurofibromatosis Type ◽

1H Mr Spectroscopy ◽

Unidentified Bright Objects

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Comparison of Intravoxel Incoherent Motion Diffusion-Weighted MR Imaging and Arterial Spin Labeling MR Imaging in Gliomas

BioMed Research International ◽

10.1155/2015/234245 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 20

Author(s):

Yuankai Lin ◽

Jianrui Li ◽

Zhiqiang Zhang ◽

Qiang Xu ◽

Zhenyu Zhou ◽

...

Keyword(s):

Diffusion Coefficient ◽

White Matter ◽

Mr Imaging ◽

Arterial Spin Labeling ◽

Spin Labeling ◽

Intravoxel Incoherent Motion ◽

Low Grade ◽

High Grade ◽

Low Grade Gliomas ◽

High Grade Gliomas

Gliomas grading is important for treatment plan; we aimed to investigate the application of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI) in gliomas grading, by comparing with the three-dimensional pseudocontinuous arterial spin labeling (3D pCASL). 24 patients (13 high grade gliomas and 11 low grade gliomas) underwent IVIM DWI and 3D pCASL imaging before operation; maps of fast diffusion coefficient (D∗), slow diffusion coefficient (D), fractional perfusion-related volume (f), and apparent diffusion coefficient (ADC) as well as cerebral blood flow (CBF) were calculated and then coregistered to generate the corresponding parameter values. We found CBF andD∗were higher in the high grade gliomas, whereas ADC,D, andfwere lower (allP<0.05). In differentiating the high from low grade gliomas, the maximum areas under the curves (AUC) ofD∗, CBF, and ADC were 0.857, 0.85, and 0.902, respectively. CBF was negatively correlated withfin tumor (r=-0.619,P=0.001). ADC was positively correlated withDin both tumor and white matter (r=0.887,P=0.000andr=0.824,P=0.000, resp.). There was no correlation between CBF andD∗in both tumor and white matter (P>0.05). IVIM DWI showed more efficiency than 3D pCASL but less validity than conventional DWI in differentiating the high from low grade gliomas.

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