title: A Novel Methodology for Applying Multivoxel MR Spectroscopy to Evaluate Convection-Enhanced Drug Delivery in Diffuse Intrinsic Pontine Gliomas.
abstract: Diffuse intrinsic pontine gliomas are inoperable high-grade gliomas with a median survival of less than 1 year. Convection-enhanced delivery is a promising local drug-delivery technique that can bypass the BBB in diffuse intrinsic pontine glioma treatment. Evaluating tumor response is critical in the assessment of convection-enhanced delivery of treatment. We proposed to determine the potential of 3D multivoxel (1)H-MR spectroscopy to evaluate convection-enhanced delivery treatment effect in these tumors.
  
  
  
  We prospectively analyzed 3D multivoxel (1)H-MR spectroscopy data for 6 patients with nonprogressive diffuse intrinsic pontine gliomas who received convection-enhanced delivery treatment of a therapeutic antibody (Phase I clinical trial NCT01502917). To compare changes in the metabolite ratios with time, we tracked the metabolite ratios Cho/Cr and Cho/NAA at several ROIs: normal white matter, tumor within the convection-enhanced delivery infusion site, tumor outside of the infused area, and the tumor average.
  
  
  
  There was a comparative decrease in both Cho/Cr and Cho/NAA metabolite ratios at the tumor convection-enhanced delivery site versus tumor outside the infused area. We used MR spectroscopy voxels with dominant white matter as a reference. The difference between changes in metabolite ratios became more prominent with increasing time after convection-enhanced delivery treatment.
  
  
  
  The comparative change in metabolite ratios between the convection-enhanced delivery site and the tumor site outside the infused area suggests that multivoxel (1)H-MR spectroscopy, in combination with other imaging modalities, may provide a clinical tool to accurately evaluate local tumor response after convection-enhanced delivery treatment.
authors.affiliation: From the Weill Medical College of Cornell University (D.I.G., R.S.), New York, NY.
authors.forename: D I
authors.identifier: 0000-0001-9980-4794
authors.initials: DI
authors.lastname: Guisado
authors.affiliation: From the Weill Medical College of Cornell University (D.I.G., R.S.), New York, NY.
authors.forename: R
authors.identifier: 0000-0002-3651-5415
authors.initials: R
authors.lastname: Singh
authors.affiliation: Departments of Radiology (S.M., A.J.T.).
authors.forename: S
authors.identifier: 0000-0001-6279-8853
authors.initials: S
authors.lastname: Minkowitz
authors.affiliation: Neurological Surgery (Z.Z., M.M.S.), Weill Medical College of Cornell University, New York, New York.
authors.forename: Z
authors.identifier: 0000-0001-5774-3823
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Departments of Radiology (S.H., K.K.P., R.J.Y., S.B.T.).
authors.forename: S
authors.identifier: 0000-0003-4673-9997
authors.initials: S
authors.lastname: Haque
authors.affiliation: Departments of Radiology (S.H., K.K.P., R.J.Y., S.B.T.) Medical Physics (K.K.P., S.B.T.), Memorial Sloan Kettering Cancer Center, New York, New York.
authors.forename: K K
authors.identifier: 0000-0002-9841-3078
authors.initials: KK
authors.lastname: Peck
authors.affiliation: Departments of Radiology (S.H., K.K.P., R.J.Y., S.B.T.).
authors.forename: R J
authors.identifier: 0000-0001-7003-3017
authors.initials: RJ
authors.lastname: Young
authors.affiliation: Departments of Radiology (S.M., A.J.T.).
authors.forename: A J
authors.identifier: 0000-0002-9281-716X
authors.initials: AJ
authors.lastname: Tsiouris
authors.affiliation: Neurological Surgery (Z.Z., M.M.S.), Weill Medical College of Cornell University, New York, New York Neurosurgery (M.M.S.).
authors.forename: M M
authors.identifier: 0000-0001-5627-4551
authors.initials: MM
authors.lastname: Souweidane
authors.affiliation: Departments of Radiology (S.H., K.K.P., R.J.Y., S.B.T.) Medical Physics (K.K.P., S.B.T.), Memorial Sloan Kettering Cancer Center, New York, New York. thakurs@mskcc.org.
authors.forename: S B
authors.identifier: 0000-0001-8090-3696
authors.initials: SB
authors.lastname: Thakur
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage*; D020295:Brain Stem Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018481:Convection; D016503:Drug Delivery Systems / Q000379:methods*; D005260:Female; D005910:Glioma / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged
chemical_list: D000970:Antineoplastic Agents