Assessment of Glioblastoma Response in the Era of Bevacizumab: Longstanding and Emergent Challenges in the Imaging Evaluation of Pseudoresponse
Glioblastoma is the deadliest primary malignant brain neoplasm, and despite the availability of many treatment options, its prognosis remains somber. Enhancement detected by magnetic resonance imaging (MRI) was considered the best imaging marker of tumor activity in glioblastoma for decades. However...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2019.00460/full |
| _version_ | 1818057504964214784 |
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| author | Octavio D. Arevalo Carolina Soto Pejman Rabiei Arash Kamali Leomar Y. Ballester Yoshua Esquenazi Jay-Jiguang Zhu Roy Francisco Riascos |
| author_facet | Octavio D. Arevalo Carolina Soto Pejman Rabiei Arash Kamali Leomar Y. Ballester Yoshua Esquenazi Jay-Jiguang Zhu Roy Francisco Riascos |
| author_sort | Octavio D. Arevalo |
| collection | DOAJ |
| description | Glioblastoma is the deadliest primary malignant brain neoplasm, and despite the availability of many treatment options, its prognosis remains somber. Enhancement detected by magnetic resonance imaging (MRI) was considered the best imaging marker of tumor activity in glioblastoma for decades. However, its role as a surrogate marker of tumor viability has changed with the appearance of new treatment regimens and imaging modalities. The antiangiogenic therapy created an inflection point in the imaging assessment of glioblastoma response in clinical trials and clinical practice. Although BEV led to the improvement of enhancement, it did not necessarily mean tumor response. The decrease in the enhancement intensity represents a change in the permeability properties of the blood brain barrier, and presumably, the switch of the tumor growth pattern to an infiltrative non-enhancing phenotype. New imaging techniques for the assessment of cellularity, blood flow hemodynamics, and biochemistry have emerged to overcome this hurdle; nevertheless, designing tools to assess tumor response more accurately, and in so doing, improve the assessment of response to standard of care (SOC) therapies and to novel therapies, remains challenging. |
| first_indexed | 2024-12-10T12:45:48Z |
| format | Article |
| id | doaj.art-b9a3a37f88ce4f33b8f4e1fd00309ab2 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-10T12:45:48Z |
| publishDate | 2019-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-b9a3a37f88ce4f33b8f4e1fd00309ab22022-12-22T01:48:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952019-05-011010.3389/fneur.2019.00460403329Assessment of Glioblastoma Response in the Era of Bevacizumab: Longstanding and Emergent Challenges in the Imaging Evaluation of PseudoresponseOctavio D. Arevalo0Carolina Soto1Pejman Rabiei2Arash Kamali3Leomar Y. Ballester4Yoshua Esquenazi5Jay-Jiguang Zhu6Roy Francisco Riascos7Department of Diagnostic and Interventional Radiology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United StatesFaculty of Medicine, Universidad Nacional de Colombia, Bogotá, ColombiaDepartment of Diagnostic and Interventional Radiology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United StatesDepartment of Diagnostic and Interventional Radiology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United StatesDepartment of Pathology and Laboratory Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United StatesVivian L. Smith Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United StatesVivian L. Smith Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United StatesDepartment of Diagnostic and Interventional Radiology, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, United StatesGlioblastoma is the deadliest primary malignant brain neoplasm, and despite the availability of many treatment options, its prognosis remains somber. Enhancement detected by magnetic resonance imaging (MRI) was considered the best imaging marker of tumor activity in glioblastoma for decades. However, its role as a surrogate marker of tumor viability has changed with the appearance of new treatment regimens and imaging modalities. The antiangiogenic therapy created an inflection point in the imaging assessment of glioblastoma response in clinical trials and clinical practice. Although BEV led to the improvement of enhancement, it did not necessarily mean tumor response. The decrease in the enhancement intensity represents a change in the permeability properties of the blood brain barrier, and presumably, the switch of the tumor growth pattern to an infiltrative non-enhancing phenotype. New imaging techniques for the assessment of cellularity, blood flow hemodynamics, and biochemistry have emerged to overcome this hurdle; nevertheless, designing tools to assess tumor response more accurately, and in so doing, improve the assessment of response to standard of care (SOC) therapies and to novel therapies, remains challenging.https://www.frontiersin.org/article/10.3389/fneur.2019.00460/fullpseudoresponsebevacizumabMRI imagingperfusion-weighted imagingMR spectroscopydiffusion weighted imaging (DWI) |
| spellingShingle | Octavio D. Arevalo Carolina Soto Pejman Rabiei Arash Kamali Leomar Y. Ballester Yoshua Esquenazi Jay-Jiguang Zhu Roy Francisco Riascos Assessment of Glioblastoma Response in the Era of Bevacizumab: Longstanding and Emergent Challenges in the Imaging Evaluation of Pseudoresponse Frontiers in Neurology pseudoresponse bevacizumab MRI imaging perfusion-weighted imaging MR spectroscopy diffusion weighted imaging (DWI) |
| title | Assessment of Glioblastoma Response in the Era of Bevacizumab: Longstanding and Emergent Challenges in the Imaging Evaluation of Pseudoresponse |
| title_full | Assessment of Glioblastoma Response in the Era of Bevacizumab: Longstanding and Emergent Challenges in the Imaging Evaluation of Pseudoresponse |
| title_fullStr | Assessment of Glioblastoma Response in the Era of Bevacizumab: Longstanding and Emergent Challenges in the Imaging Evaluation of Pseudoresponse |
| title_full_unstemmed | Assessment of Glioblastoma Response in the Era of Bevacizumab: Longstanding and Emergent Challenges in the Imaging Evaluation of Pseudoresponse |
| title_short | Assessment of Glioblastoma Response in the Era of Bevacizumab: Longstanding and Emergent Challenges in the Imaging Evaluation of Pseudoresponse |
| title_sort | assessment of glioblastoma response in the era of bevacizumab longstanding and emergent challenges in the imaging evaluation of pseudoresponse |
| topic | pseudoresponse bevacizumab MRI imaging perfusion-weighted imaging MR spectroscopy diffusion weighted imaging (DWI) |
| url | https://www.frontiersin.org/article/10.3389/fneur.2019.00460/full |
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