Evaluation of dynamic contrast-enhanced MRI derived microvascular permeability in recurrent glioblastoma treated with bevacizumab

• Verfasst von: Vollmuth, Philipp [VerfasserIn]
• Verfasst von: Wiestler, Benedikt [VerfasserIn]
• Verfasst von: Graf, Markus [VerfasserIn]
• Verfasst von: Heiland, Sabine [VerfasserIn]
• Verfasst von: Schlemmer, Heinz-Peter [VerfasserIn]
• Verfasst von: Wick, Wolfgang [VerfasserIn]
• Verfasst von: Wick, Antje [VerfasserIn]
• Verfasst von: Bendszus, Martin [VerfasserIn]
• Verfasst von: Radbruch, Alexander [VerfasserIn]
• Titel: Evaluation of dynamic contrast-enhanced MRI derived microvascular permeability in recurrent glioblastoma treated with bevacizumab
• Verf.angabe: Philipp Kickingereder, Benedikt Wiestler, Markus Graf, Sabine Heiland, Heinz Peter Schlemmer, Wolfgang Wick, Antje Wick, Martin Bendszus, Alexander Radbruch
• Jahr: 2015
• Jahr des Originals: 2014
• Umfang: 8 S.
• Fussnoten: Published online: 31 October 2014 ; Gesehen am 29.06.2020
• Titel Quelle: Enthalten in: Journal of neuro-oncology
• Ort Quelle: Dordrecht [u.a.] : Springer Science + Business Media B.V, 1983
• Jahr Quelle: 2015
• Band/Heft Quelle: 121(2015), 2, Seite 373-380
• ISSN Quelle: 1573-7373
• DOI: doi:10.1007/s11060-014-1644-6
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1702889807

Abstract

Bevacizumab, an antibody to vascular endothelial growth factor, is commonly used in the setting of recurrent glioblastoma (rGB). The aim of the present study was to evaluate whether dynamic-contrast-enhanced MRI (DCE-MRI) derived microvascular permeability is related to bevacizumab treatment outcome in rGB. Twenty-two patients with rGB underwent DCE-MRI at a median of 2.6 weeks prior initializing bevacizumab therapy. Follow-up MRI-scans (DCE-MRI available for 19/22 patients) were obtained after a median of 9.9 weeks. The volume transfer constant (Ktrans)—an estimate related to microvascular permeability—at baseline and voxel-wise-reduction (VWR) in Ktrans at first follow-up were measured from the entire contrast-enhancing tumor (CET) and correlated with progression-free and overall survival (PFS, OS) using uni- and multivariate cox-regression (significance-level p < 0.05). Baseline Ktrans ranged from 0.050 to 0.205 min−1 (median, 0.109 min−1). The VWR in Ktrans ranged from 19.9 to 97.2 % (median, 89.4 %). Patients with lower baseline Ktrans and higher VWR in Ktrans showed significantly longer PFS and OS. Given the strong correlation of VWR in Ktrans and CET-volume changes (Spearman’s ρ = −0.73, p < 0.01) both variables were included in a multivariate model. Thereby, neither VWR in Ktrans nor CET-volume changes retained independent significance for PFS or OS. Pre-treatment Ktrans stratifies PFS and OS in patients with bevacizumab-treated rGB. Although early pharmacodynamics changes in Ktrans were not assessed, the VWR in Ktrans at first follow-up had no additional benefit over assessment of CET-volume changes. Further prospective trials are needed to confirm these findings and to elucidate the potential role of pre-treatment Ktrans as a predictive and/or prognostic biomarker.