Computerized assessment of vessel morphological changes during treatment of glioblastoma multiforme: report of a case imaged serially by MRA over four years.


Journal Article

A patient with glioblastoma multiforme underwent serial computerized analysis of tumor-associated vasculature defined from magnetic resonance angiographic (MRA) scans obtained over almost a four year period. The clinical course included tumor resection with subsequent radiation therapy, a long symptom-free interval, emergence of a new malignant focus, resection of that focus, a stroke, and treatment with chemotherapy and anti-angiogenic therapy. Image analysis methods included segmentation of vessels from each MRA and statistical comparison of vessel morphology over 4 regions of interest (the initial tumor site, the second tumor site, a distant control region, and the entire brain) to the same 4 regions of interest in 50 healthy volunteers (26 females and 24 males; mean age 39 years). Results suggested that following completion of focal radiation therapy (RT) vessel shape abnormalities, if elevated at the time of RT completion, may progressively normalize for months in focal regions, that progressively severe vessel shape abnormalities can precede the emergence of a gadolinium enhancing lesion by months, that lesion resection can produce a dramatic but highly transient drop in abnormal vessel tortuosity both focally and globally, and that treatment with anti-angiogenic agents does not necessarily normalize vessel shape. Quantitative measurements of vessel morphology as defined from MRA may provide useful insights into tumor development and response to therapy.

Full Text

Duke Authors

Cited Authors

  • Bullitt, E; Ewend, M; Vredenburgh, J; Friedman, A; Lin, W; Wilber, K; Zeng, D; Aylward, SR; Reardon, D

Published Date

  • August 2009

Published In

Volume / Issue

  • 47 Suppl 2 /

Start / End Page

  • T143 - T151

PubMed ID

  • 19103295

Pubmed Central ID

  • 19103295

Electronic International Standard Serial Number (EISSN)

  • 1095-9572

Digital Object Identifier (DOI)

  • 10.1016/j.neuroimage.2008.10.067


  • eng

Conference Location

  • United States