Role of Functional Diffusion Maps as an Imaging Biomarker for Treatment Response Assessment in Recurrent/progressive Malignant Gliomas Treated with Bevacizumab

Rajan Jain¹, Shehanaz Ellika, Lisa Scarpace, Roy Torcuator, Lonni Schultz, David Hearshen, Tom Mikkelsen

Imaging criteria of measuring tumor area/volume only, to assess treatment response may not be sufficient in patients on anti-angiogenic therapy and other functional imaging biomarkers such as ADC values can be helpful in treatment response assessment of these patients. In the present study, recurrent/progressive malignant gliomas treated with bevacizumab, CELADC (contrast enhancing lesion ADC) and NELADC (non-enhancing lesion ADC) showed a progressive increase in responders suggesting treatment response, probable tumor cell death and decreasing tumor cell density. Non-responders showed a progressive decrease of CELADC and NELADC suggesting increase of tumor cell density, hyper cellular infiltrative tumor growth and treatment failure.