Department of Radiological Sciences, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, CA 90095, USA.
Neuro Oncol. 2011 Apr;13(4):401-9. doi: 10.1093/neuonc/noq206. Epub 2011 Feb 15.
Although the effects of bevacizumab on magnetic resonance images (MRIs) of recurrent glioblastoma multiforme (GBM) are well documented, to our knowledge, no studies have explicitly quantified the volumetric changes resulting from initial treatment, nor have there been studies examining the ability for volumetric changes in conventional MRI to predict progression-free survival (PFS) and overall survival (OS). In the current study, we retrospectively examined volumetric changes on conventional MRI scans in 84 patients with recurrent GBM. MRIs were obtained before (mean, 11 days) and after (mean, 42 days) treatment with bevacizumab. The volume of abnormal fluid-attenuated inversion recovery (FLAIR) signal intensity, the volume of contrast enhancement, and the ratio of the 2 were quantified for each patient before and after initial treatment. Results demonstrated that initial treatment with bevacizumab resulted in a significant decrease in both the volume of abnormal FLAIR signal and the volume of contrast enhancement. Initial, residual, and change in FLAIR volume were not predictive of PFS or OS. Initial contrast-enhancing volume was predictive of PFS but not OS. The pretreatment relative nonenhancing tumor ratio, defined as the ratio of FLAIR to contrast-enhancing volume, was found to be predictive of both PFS and OS.
尽管贝伐单抗对复发性多形性胶质母细胞瘤（GBM）磁共振成像（MRI）的影响已有充分记录，但据我们所知，尚无研究明确量化初始治疗引起的体积变化，也没有研究探讨常规 MRI 中的体积变化是否能够预测无进展生存期（PFS）和总生存期（OS）。在本研究中，我们回顾性检查了 84 例复发性 GBM 患者的常规 MRI 扫描中的体积变化。在接受贝伐单抗治疗之前（平均 11 天）和之后（平均 42 天）获得 MRI。对每位患者在初始治疗前后分别量化异常液体衰减反转恢复（FLAIR）信号强度的体积、对比增强的体积以及两者的比值。结果表明，贝伐单抗的初始治疗导致异常 FLAIR 信号和对比增强的体积均显著下降。初始、残留和 FLAIR 体积变化均不能预测 PFS 或 OS。初始对比增强体积可预测 PFS，但不能预测 OS。治疗前相对无增强肿瘤比，定义为 FLAIR 与对比增强体积的比值，可预测 PFS 和 OS。
