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- Publisher
- American Journal of Neuroradiology
- Copyright
- © 2016 by American Journal of Neuroradiology
- ISSN
- 0195-6108
- eISSN
- 1936-959X
- DOI
- 10.3174/ajnr.A4898
- pmid
- 27492073
- Publisher site
- See Article on Publisher Site
Abstract
ORIGINAL RESEARCH ADULT BRAIN Progressing Bevacizumab-Induced Diffusion Restriction Is Associated with Coagulative Necrosis Surrounded by Viable Tumor and Decreased Overall Survival in Patients with Recurrent Glioblastoma X H.S. Nguyen, X N. Milbach, X S.L. Hurrell, X E. Cochran, X J. Connelly, X J.A. Bovi, X C.J. Schultz, X W.M. Mueller, X S.D. Rand, X K.M. Schmainda, and X P.S. LaViolette ABSTRACT BACKGROUND AND PURPOSE: Patients with recurrent glioblastoma often exhibit regions of diffusion restriction following the initiation of bevacizumab therapy. Studies suggest that these regions represent either diffusion-restricted necrosis or hypercellular tumor. This study ex- plored postmortem brain specimens and a population analysis of overall survival to determine the identity and implications of such lesions. MATERIALS AND METHODS: Postmortem examinations were performed on 6 patients with recurrent glioblastoma on bevacizumab with progressively growing regions of diffusion restriction. ADC values were extracted from regions of both hypercellular tumor and necrosis. A receiver operating characteristic analysis was performed to define optimal ADC thresholds for differentiating tissue types. A retrospective population study was also performed comparing the overall survival of 64 patients with recurrent glioblastoma treated with bevacizumab. Patients were separated into 3 groups: no diffusion restriction, diffusion restriction that appeared and
Journal
American Journal of Neuroradiology – American Journal of Neuroradiology
Published: Dec 1, 2016