Translational Brain Tumor Research Program, Medical College of Wisconsin, Milwaukee, WI, USA.
J Neurooncol. 2011 Mar;102(1):95-103. doi: 10.1007/s11060-010-0293-7. Epub 2010 Aug 27.
Anti-angiogenic agents targeting brain tumor neovasculature may increase progression-free survival in patients with recurrent malignant gliomas. However, when these patients do recur it is not always apparent as an increase in enhancing tumor volume on MRI, which has been the standard of practice for following patients with brain tumors. Therefore alternative methods are needed to evaluate patients treated with these novel therapies. Furthermore, a method that can also provide useful information for the evaluation of conventional therapies would provide an important advantage for general applicability. Diffusion-weighted magnetic resonance imaging (DWI) has the potential to serve as a valuable biomarker for these purposes. In the current study, we explore the prognostic ability of functional diffusion maps (fDMs), which examine voxel-wise changes in the apparent diffusion coefficient (ADC) over time, applied to regions of fluid-attenuated inversion recovery (FLAIR) abnormalities in patients with malignant glioma, treated with either anti-angiogenic or cytotoxic therapies. Results indicate that the rate of change in fDMs is an early predictor of tumor progression, time to progression and overall survival for both treatments, suggesting the application of fDMs in FLAIR abnormal regions may be a significant advance in brain tumor biomarker technology.
针对脑肿瘤新生血管的抗血管生成药物可能会增加复发性恶性胶质瘤患者的无进展生存期。然而，当这些患者确实复发时，MRI 上增强肿瘤体积的增加并不总是明显的，这一直是监测脑肿瘤患者的标准做法。因此，需要替代方法来评估接受这些新型治疗的患者。此外，对于评估常规治疗方法有用的方法也将为普遍适用性提供重要优势。扩散加权磁共振成像 (DWI) 有可能成为这些目的的有价值的生物标志物。在当前的研究中，我们探讨了功能扩散图 (fDM) 的预后能力，fDM 检查了随时间推移表观扩散系数 (ADC) 的体素变化，应用于接受抗血管生成或细胞毒性治疗的恶性胶质瘤患者的液体衰减反转恢复 (FLAIR) 异常区域。结果表明，fDM 的变化率是两种治疗方法的肿瘤进展、进展时间和总生存期的早期预测指标，这表明在 FLAIR 异常区域应用 fDM 可能是脑肿瘤生物标志物技术的重大进展。
