Kathleen M. Schmainda1,2, Devyani Bedekar1, Scott D. Rand1, Jennifer Connelly3, Shekar Kurpad4, Hendrikus G. J. Krouwer5, Eric S. Paulson6, Mark G. Malkin3,4
1Radiology, Medical College of Wisconsin, Milwaukee, WI, USA; 2Biophysics, Medical College of Wisconsin, Milwaukee, WI, USA; 3Neurology, Medical College of Wisconsin, Milwaukee, WI, USA; 4Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA; 5Regional Cancer Center, Waukesha Memorial Hospital, Waukesha, WI, USA; 6Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA
The anti-VEGF (vascular endotholelial growth factor) antibody, bevacizumab, is in clinical testing for the treatment of gliomas with promising results. However, it is quickly becoming apparent that evaluation of response, using standard measures such as enhancing tumor volume or the extent of T2-weighted abnormalities on MRI, are often unreliable. In this study of recurrent high-grade glioma patients, treated with bevacizumab plus irinotecan, we demonstrate that DSC-derived measures of relative cerebral blood volume (rCBV) while similar to standard MRI for predicting response are much more reliable, early predictors of treatment failure and disease progression compared to standard MRI methods of evaluation.