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Vascular biomarkers derived from dynamic contrast-enhanced MRI predict response of vestibular schwannoma to antiangiogenic therapy in type 2 neurofibromatosis.
Li, Ka-Loh; Djoukhadar, Ibrahim; Zhu, Xiaoping; Zhao, Sha; Lloyd, Simon; McCabe, Martin; McBain, Catherine; Evans, D Gareth; Jackson, Alan.
Affiliation
  • Li KL; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
  • Djoukhadar I; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
  • Zhu X; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
  • Zhao S; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
  • Lloyd S; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
  • McCabe M; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
  • McBain C; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
  • Evans DG; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
  • Jackson A; Wolfson Molecular Imaging Centre, The University of Manchester, Manchester, UK (K.-L.L., I.D., X.Z., S.Z., A.J.); Institute of Population Health, The University of Manchester, Manchester, UK (K.-L.L., I.D., A.J.); Genomic Medicine, The University of Manchester, Manchester Academic Health Science Cen
Neuro Oncol ; 18(2): 275-82, 2016 Feb.
Article in En | MEDLINE | ID: mdl-26311690
ABSTRACT

BACKGROUND:

Antiangiogenic therapy of vestibular schwannoma (VS) in type 2 neurofibromatosis can produce tumor shrinkage with response rates of 40%-60%. This study examines the predictive value of parameter-derived MRI in this setting.

METHODS:

Twelve patients with 20 VSs were recruited. Each had at least one rapidly growing tumor. Patients were treated with bevacizumab, 5 mg/kg every 2 weeks. Patients with stable or reduced VS volume were maintained at 2.5-5 mg every 4 weeks after 6 months. Those who failed treatment had their bevacizumab discontinued. Dynamic contrast-enhanced (DCE) MRI performed prior to treatment using a high temporal resolution technique, and data were analyzed to allow measurement of contrast transfer coefficient (K(trans)), vascular fraction (v(p)), extravascular-extracellular fraction (v(e)). Relaxation rate (R1(N)) was measured using a variable flip angle technique. Apparent diffusional coefficient (ADC) was calculated from diffusion-weighted imaging. The predictive power of microvascular parameters and ADC were examined using logistic regression modeling.

RESULTS:

Responding tumors were larger (P < .001), had lower R1(N) (P < .001), and higher K(trans) (P < .05) and ADC (P < .01). They showed increases in R1(N) (P < .01) and reduction of K(trans) (P < .01) and ADC (P < .01). Modeling to predict response demonstrated significant independent predictive power for R1(N) (Β = - 0.327, P < .001), and K(trans) (Β = 0.156, P < .05). Modeling to predict percentage change in tumor volume at 90 days identified baseline tumor volume (Β = 5.503, P < .05), R1(N) (Β = - 5.844, P < .05), and K(trans) (Β = 5.622, P < .05) as independent significant predictors.

CONCLUSIONS:

In patients with type 2 neurofibromatosis, biomarkers from DCE-MRI are predictive of VS volume response to inhibition of vascular endothelial growth factor inhibition.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Magnetic Resonance Imaging / Biomarkers, Tumor / Neuroma, Acoustic / Neurofibromatosis 2 / Contrast Media / Angiogenesis Inhibitors / Bevacizumab Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Female / Humans / Male / Middle aged Language: En Journal: Neuro Oncol Journal subject: NEOPLASIAS / NEUROLOGIA Year: 2016 Document type: Article
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Magnetic Resonance Imaging / Biomarkers, Tumor / Neuroma, Acoustic / Neurofibromatosis 2 / Contrast Media / Angiogenesis Inhibitors / Bevacizumab Type of study: Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adolescent / Adult / Female / Humans / Male / Middle aged Language: En Journal: Neuro Oncol Journal subject: NEOPLASIAS / NEUROLOGIA Year: 2016 Document type: Article