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Dynamic contrast-enhanced MRI may be helpful to predict response and prognosis after bevacizumab treatment in patients with recurrent high-grade glioma: comparison with diffusion tensor and dynamic susceptibility contrast imaging

 Yae Won Park  ;  Sung Soo Ahn  ;  Ju Hyung Moon  ;  Eui Hyun Kim  ;  Seok-Gu Kang  ;  Jong Hee Chang  ;  Se Hoon Kim  ;  Seung-Koo Lee 
 NEURORADIOLOGY, Vol.63(11) : 1811-1822, 2021-11 
Journal Title
Issue Date
Bevacizumab / therapeutic use ; Brain Neoplasms* / diagnostic imaging ; Brain Neoplasms* / drug therapy ; Contrast Media ; Diffusion Tensor Imaging ; Glioma* / diagnostic imaging ; Glioma* / drug therapy ; Humans ; Magnetic Resonance Imaging ; Neoplasm Recurrence, Local / diagnostic imaging ; Neoplasm Recurrence, Local / drug therapy ; Prognosis
Bevacizumab ; Diffusion tensor imaging ; Glioma ; Magnetic resonance imaging
Purpose: We aimed to evaluate the utility of diffusion tensor imaging (DTI), dynamic contrast-enhanced (DCE), and dynamic susceptibility contrast (DSC) imaging for stratifying bevacizumab treatment outcomes in patients with recurrent high-grade glioma.

Methods: Fifty-three patients with recurrent high-grade glioma who underwent baseline magnetic resonance imaging including DTI, DCE, and DSC before bevacizumab treatment were included. The mean apparent diffusion coefficient, fractional anisotropy, normalized cerebral blood volume, normalized cerebral blood flow, volume transfer constant, rate transfer coefficient (Kep), extravascular extracellular volume fraction, and plasma volume fraction were assessed. Predictors of response status, progression-free survival (PFS), and overall survival (OS) were determined using logistic regression and Cox proportional hazard modeling.

Results: Responders (n = 16) showed significantly longer PFS and OS (P < 0.001) compared with nonresponders (n = 37). Multivariable analysis revealed that lower mean Kep (odds ratio = 0.01, P = 0.008) was the only independent predictor of favorable response after adjustment for age, isocitrate dehydrogenase (IDH) mutation status, and O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation status. Multivariable Cox proportional hazard modeling showed that a higher mean Kep was the only variable associated with shorter PFS (hazard ratio [HR] = 7.90, P = 0.006) and OS (HR = 9.71, P = 0.020) after adjustment for age, IDH mutation status, and MGMT promoter methylation status.

Conclusion: Baseline mean Kep may be a useful biomarker for predicting response and stratifying patient outcomes following bevacizumab treatment in patients with recurrent high-grade glioma.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Gu(강석구) ORCID logo https://orcid.org/0000-0001-5676-2037
Kim, Se Hoon(김세훈) ORCID logo https://orcid.org/0000-0001-7516-7372
Kim, Eui Hyun(김의현) ORCID logo https://orcid.org/0000-0002-2523-7122
Moon, Ju Hyung(문주형)
Park, Yae Won(박예원) ORCID logo https://orcid.org/0000-0001-8907-5401
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-0503-5558
Lee, Seung Koo(이승구) ORCID logo https://orcid.org/0000-0001-5646-4072
Chang, Jong Hee(장종희) ORCID logo https://orcid.org/0000-0003-1509-9800
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