Pseudo-Tumoral Response of Glioblastoma to Anti-Angiogenic Treatment Prematurely Revealed by Using Arterial Spin-Labeling (ASL) Perfusion MRI and Susceptibility Weighted Imaging (SWI).

Slim Fellah¹, Yann Lefur¹, Elisabeth Soulier¹, Cline Boucard², Sylviane Confort-Gouny¹, Olivier Chinot², Patrick J. Cozzone¹, Jean-Philippe Ranjeva¹, Virginie Callot¹

Anti-angiogenics have become part of Glioblastoma therapeutic protocol. However pseudo-response followed by a critical recurrence may be observed. Non-responders thus need to be prematurely identified. However current imaging criteria are insufficient or late, new MR markers should therefore be investigated. In this preliminary study, we used a multimodal protocol including particularly ASL and SWI, which provide vascular information. A few weeks after the beginning of the treatment, FLAIR and post-contrast T1-WI showed partial response whereas perfusion MRI and SWI demonstrated hyperperfusion and vascularization increase. The parameters derived from such sequences should thus be considered as early indicators of tumor evolution.