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Combining diffusion and perfusion differentiates tumor from bevacizumab-related imaging abnormality (bria).

Publication ,  Journal Article
Farid, N; Almeida-Freitas, DB; White, NS; McDonald, CR; Kuperman, JM; Almutairi, AA; Muller, KA; VandenBerg, SR; Kesari, S; Dale, AM
Published in: J Neurooncol
December 2014

A subset of patients with high-grade glioma and brain metastases who are treated with bevacizumab develop regions of marked and persistent restricted diffusion that do not reflect recurrent tumor. Here, we quantify the degree of restricted diffusion and the relative cerebral blood volume (rCBV) within these regions of bevacizumab-related imaging abnormality (BRIA) in order to facilitate differentiation of these lesions from recurrent tumor. Six patients with high-grade glioma and two patients with brain metastases who developed regions of restricted diffusion after initiation of bevacizumab were included. Six pre-treatment GBM controls were also included. Restriction spectrum imaging (RSI) was used to create diffusion maps which were co-registered with rCBV maps. Within regions of restricted diffusion, mean RSI values and mean rCBV values were calculated for patients with BRIA and for the GBM controls. These values were also calculated for normal-appearing white matter (NAWM). RSI values in regions of restricted diffusion were higher for both BRIA and tumor when compared to NAWM; furthermore RSI values in BRIA were slightly higher than in tumor. Conversely, rCBV values were very low in BRIA-lower than both tumor and NAWM. However, there was only a trend for rCBV values to be higher in tumor than in NAWM. When evaluating areas of restricted diffusion in patients with high-grade glioma or brain metastases treated with bevacizumab, RSI is better able to detect the presence of pathology whereas rCBV is better able to differentiate BRIA from tumor. Thus, combining these tools may help to differentiate necrotic tissue related to bevacizumab treatment from recurrent tumor.

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Published In

J Neurooncol

DOI

EISSN

1573-7373

Publication Date

December 2014

Volume

120

Issue

3

Start / End Page

539 / 546

Location

United States

Related Subject Headings

  • White Matter
  • Perfusion Imaging
  • Oncology & Carcinogenesis
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Humans
  • Glioma
  • Female
  • Diffusion Magnetic Resonance Imaging
 

Citation

APA
Chicago
ICMJE
MLA
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Farid, N., Almeida-Freitas, D. B., White, N. S., McDonald, C. R., Kuperman, J. M., Almutairi, A. A., … Dale, A. M. (2014). Combining diffusion and perfusion differentiates tumor from bevacizumab-related imaging abnormality (bria). J Neurooncol, 120(3), 539–546. https://doi.org/10.1007/s11060-014-1583-2
Farid, Nikdokht, Daniela B. Almeida-Freitas, Nathan S. White, Carrie R. McDonald, Joshua M. Kuperman, Abdulrahman A. Almutairi, Karra A. Muller, Scott R. VandenBerg, Santosh Kesari, and Anders M. Dale. “Combining diffusion and perfusion differentiates tumor from bevacizumab-related imaging abnormality (bria).J Neurooncol 120, no. 3 (December 2014): 539–46. https://doi.org/10.1007/s11060-014-1583-2.
Farid N, Almeida-Freitas DB, White NS, McDonald CR, Kuperman JM, Almutairi AA, et al. Combining diffusion and perfusion differentiates tumor from bevacizumab-related imaging abnormality (bria). J Neurooncol. 2014 Dec;120(3):539–46.
Farid, Nikdokht, et al. “Combining diffusion and perfusion differentiates tumor from bevacizumab-related imaging abnormality (bria).J Neurooncol, vol. 120, no. 3, Dec. 2014, pp. 539–46. Pubmed, doi:10.1007/s11060-014-1583-2.
Farid N, Almeida-Freitas DB, White NS, McDonald CR, Kuperman JM, Almutairi AA, Muller KA, VandenBerg SR, Kesari S, Dale AM. Combining diffusion and perfusion differentiates tumor from bevacizumab-related imaging abnormality (bria). J Neurooncol. 2014 Dec;120(3):539–546.
Journal cover image

Published In

J Neurooncol

DOI

EISSN

1573-7373

Publication Date

December 2014

Volume

120

Issue

3

Start / End Page

539 / 546

Location

United States

Related Subject Headings

  • White Matter
  • Perfusion Imaging
  • Oncology & Carcinogenesis
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Humans
  • Glioma
  • Female
  • Diffusion Magnetic Resonance Imaging