title: Bevacizumab treatment for symptomatic radiation necrosis diagnosed by amino acid PET.
abstract: Bevacizumab is effective in treating radiation necrosis; however, radiation necrosis was not definitively diagnosed in most previous reports. Here we used amino acid positron emission tomography to diagnose radiation necrosis for the application of bevacizumab in treating progressive radiation necrosis. Lesion/normal tissue ratios of <2.5 on (18)fluoride-labeled boronophenylalanine-positron emission tomography were defined as an indication of effective bevacizumab treatment. Thirteen patients were treated with bevacizumab at a dose of 5 mg/kg every 2 weeks. Two patients were excluded because of adverse events. The median reduction rate in perilesional edema was 65.5%. Karnofsky performance status improved in six patients after bevacizumab treatment. Lesion/normal tissue ratios on (18)fluoride-labeled boronophenylalanine-positron emission tomography (P = 0.0084) and improvement in Karnofsky performance status after bevacizumab treatment (P = 0.0228) were significantly associated with reduced rates of perilesional edema. Thus, (18)fluoride-labeled boronophenylalanine-positron emission tomography could be useful for diagnosing radiation necrosis and predicting the efficacy of bevacizumab in progressive radiation necrosis.
authors.affiliation: Department of Neurosurgery, Osaka Medical College, 2-7, Daigakumachi, Takatsuki, Osaka, Japan. neu054@poh.osaka-med.ac.jp
authors.forename: Motomasa
authors.initials: M
authors.lastname: Furuse
authors.forename: Naosuke
authors.initials: N
authors.lastname: Nonoguchi
authors.forename: Shinji
authors.initials: S
authors.lastname: Kawabata
authors.forename: Erina
authors.initials: E
authors.lastname: Yoritsune
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Takahashi
authors.forename: Taisuke
authors.initials: T
authors.lastname: Inomata
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Kuroiwa
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Miyatake
mesh_terms: D000328:Adult; D000368:Aged; D000596:Amino Acids; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D011832:Radiation Injuries / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011878:Radiotherapy / Q000009:adverse effects; D014055:Tomography, Emission-Computed / Q000379:methods*
chemical_list: D000596:Amino Acids; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab