Article Figures & Data
Figures
- Fig 1.
A 67-year-old man with left parietal GBM status after resection and chemoradiation. Top row shows the T1 postcontrast–T1 precontrast (A), FLAIR (B), ADC (C), and RSI-CM (D) images before the start of bevacizumab, while the middle row shows the T1 postcontrast–T1 precontrast (E), FLAIR (F), ADC (G), and RSI-CM (H) images after the initiation of bevacizumab. Arrowheads indicate the contrast-enhancing region (green), the surrounding region of FLAIR-HI (yellow), and the region of RD on RSI-CMs (red). Although there is a decrease in contrast enhancement and surrounding FLAIR-HI after the initiation of bevacizumab, the region of RD increases and becomes more confluent; this change suggests worsening residual/recurrent tumor. Moreover, this increase in the region of RD is much more conspicuous on RSI-CMs compared with the ADC. The bottom row depicts these changes on “change maps” (change in T1 postcontrast–precontrast) (I), change in FLAIR (J), change in ADC (K), and change in the RSI-CMs (L), with red-yellow indicating an increase in signal intensity and blue-cyan indicating a decrease in signal intensity. Note that on the ADC change map (K), the area of increased RD is essentially masked by the decreased signal intensity within the region of surrounding FLAIR-HI.
- Fig 2.
Bar graphs depicting the mean normalized intensity values (z scores) of the RSI-CMs (A) and the ADC (B) in regions of RD and FLAIR-HI before and on treatment with bevacizumab. Error bars reflect the standard error.
- Fig 3.
Scatterplot of the relationship between change in ADC z scores (on treatment–pretreatment) and change in FLAIR-HI z scores (on treatment–pretreatment) within the regions of FLAIR-HI. Z scores represent intensity values normalized to NAWM.
Tables
Demographic and treatment-related characteristics of the patient sample
Patient Age (yr)/Sex Pathology Initial Therapy Surgery Prior to Bevacizumab Scan (mo)a Pre and Post-Bevacizumab Scans (day)b Post-Bevacizumab Pathologyc 1 58/F GBM WHO IV XRT + TMZ; TMZ 5/28 GTR, 1 −31, +29 – 2 43/M AGN/WHO III/IV XRT + TMZ; TMZ 3/14 GTR, 12 −22, +16 AA/WHO III/IV 3 62/F GBM / WHO IV XRT + TMZ; TMZ 3/14 STR, 1+ −3, +112 GBM/WHO IV 4 49/M GBM/WHO IV XRT + TMZ; TMZ 3/14 STR, 1 −10, +22 – 5 57/F GBM/WHO IV XRT + TMZ; TMZ 5/28, TMZ 3/14 STR, 6+ −13, +49 GBM/WHO IV 6 63/F GBM/WHO IV XRT + TMZ; TMZ 5/28 STR, 1 −28, +46 GBM/WHO IV + radiation effect 7 66/M GBM/WHO IV XRT + TMZ; TMZ 5/28 STR, 5 −2, +34 GBM/WHO IV + radiation necrosis 8 56/M AOA/WHO III XRT + TMZ; TMZ 5/28 RXN, 4+ −15 days, +15 – 9 67/M GBM/WHO IV XRT + TMZ; TMZ 5/28 GTR, 7 −7, +29 days – 10 27/F AA/WHO III XRT + TMZ Bx, 2+ −8, +16 – 11 40/M GBM/WHO IV XRT + TMZ; TMZ 5/28 STR, 5+ −37, +35 – 12 56/M GBM/WHO IV XRT + TMZ; TMZ 5/28 STR, 7 −49, +27 – Note:—AOA indicates anaplastic oligoastrocytoma; AA, anaplastic astrocytoma; XRT + TMZ, radiotherapy plus adjuvant temozolomide; TMZ 5/28, temozolomide for 5 days every 28 days; TMZ 3/14, temozolomide for 3 days every 14 days; GTR, gross total resection; STR, subtotal resection; RXN, craniotomy and resection; Bx, biopsy; AGN, anaplastic glioneural neoplasm; WHO = World Health Organization.
↵a Months shown indicate the interval between the surgical event and the first scan obtained during bevacizumab treatment.
↵b Interval in days between the scan prior to bevacizumab treatment (pre-bevacizumab scan), and initiation of bevacizumab therapy, followed by the interval in days between initiation of bevacizumab therapy and first scan during bevacizumab treatment (post-bevacizumab scan).
↵c Pathology after bevacizumab therapy had started.
Jump to section
Related Articles
Cited By...
- Characterization of the Diffusion Signal of Breast Tissues using Multi-exponential Models
- Edge Contrast of the FLAIR Hyperintense Region Predicts Survival in Patients with High-Grade Gliomas following Treatment with Bevacizumab
- Lessons From Anti-Vascular Endothelial Growth Factor and Anti-Vascular Endothelial Growth Factor Receptor Trials in Patients With Glioblastoma
- Diffusion-Weighted Imaging in Cancer: Physical Foundations and Applications of Restriction Spectrum Imaging
- Advanced Magnetic Resonance Imaging of the Physical Processes in Human Glioblastoma
- Pretreatment ADC Histogram Analysis Is a Predictive Imaging Biomarker for Bevacizumab Treatment but Not Chemotherapy in Recurrent Glioblastoma