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Abstract #0978

Classification of Hyperintense FLAIR Lesion Area in Patients with Glioblastoma Following Treatment with Bevacizumab

Moran Artzi1, 2, Orna Aizenstein3, Deborah T. Blumenthal4, Felix Bokstein4, Benjamin W. Corn5, 6, Dafna Ben Bashat3

1The Functional Brain Center, The Wohl Institute for Advanced Imaging , Tel Aviv Sourasky Medical Center, Tel Aviv , Israel; 2Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel; 3The Functional Brain Center, The Wohl Institute for Advanced Imaging , Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; 4Neuro-Oncology Service, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; 5Institute of Radiotherapy, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; 6Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel


Following bevacizumab(BVZ) therapy in patients with glioblastoma (GB), a pattern of non-enhancing tumor progression was reported, characterized by areas with hyperintense T2-weighted signal. This study aimed to differentiate between the vasogenic and tumor components in these areas, based on diffusion and perfusion MRI. Thirteen GB patients were scanned before and during BVZ therapy (total 37 scans). Unsupervised segmentation was performed on the non-enhancing hyperintense FLAIR areas, clustering into: vasogenic edema, intermediate and active tumor. A decrease in vasogenic edema, along with a trend of increased tumor-related components was detected, supporting the concept of infiltrative tumor progression pattern following BVZ therapy.