title: Early response evaluation for recurrent high grade gliomas treated with bevacizumab: a volumetric analysis using diffusion-weighted imaging.
abstract: Bevacizumab is a novel treatment for the recurrent high-grade gliomas (rHGG). However, only a subset of the patients shows response to the bevacizumab treatment and the response evaluation using conventional criteria is difficult. The purpose of our study was to evaluate the early response for rHGG treated with bevacizumab using volumetric analysis of diffusion-weighted imaging (DWI). Twenty-nine patients who received bevacizumab therapy for rHGG were included in our study. All patients received a conventional MRI scan with DWI before and after the initial bevacizumab dose. For each MRI, we measured the total volume of the T2 hyperintense lesion (HT2) of the rHGG, the volume of foci with a lower ADC value than that of the normal cortex (LADC), and the proportion of LADC to HT2 (LADC/HT2). The Changes in the HT2, LADC and LADC/HT2 after bevacizumab treatment were also determined. Thereafter, those volumetric data were compared to the progression free survival (PFS). After the analyses, we found a significant negative correlation between the PFS and the LADC for the post-bevacizumab ADC maps (r = -0.413, P = 0.026). The patients with an LADC of <2.5 cm(3) showed a longer PFS than those with an LADC of ≥2.5 cm(3) (median = 135 vs. 91 days, P = 0.002) on the post-bevacizumab ADC maps. A multiple linear regression analysis revealed that only the post-bevacizumab LADC was a significant predictor of the PFS (P = 0.026). In conclusion, the post-bevacizumab LADC can be used for an early response evaluation and can predict the PFS for rHGG patients treated with bevacizumab.
authors: Department of Radiology, Seoul National University College of Medicine, 28, Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.
authors: Eui Jin
authors: EJ
authors: Hwang
authors: Yongjun
authors: Y
authors: Cha
authors: A Leum
authors: AL
authors: Lee
authors: Tae Jin
authors: TJ
authors: Yun
authors: Tae Min
authors: TM
authors: Kim
authors: Chul-Kee
authors: CK
authors: Park
authors: Ji-Hoon
authors: JH
authors: Kim
authors: Chul-Ho
authors: CH
authors: Sohn
authors: Sung-Hye
authors: SH
authors: Park
authors: Il Han
authors: IH
authors: Kim
authors: Dae Seog
authors: DS
authors: Heo
authors: Se-Hoon
authors: SH
authors: Lee
authors: Seung Hong
authors: SH
authors: Choi
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D038524:Diffusion Magnetic Resonance Imaging; D018572:Disease-Free Survival; D005260:Female; D005910:Glioma / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab