Imaging response, in patients with recurrent glioblastoma (rGBM) who are treated with bevacizumab (which decreases vascular permeability), is often difficult to assess since decreased contrast agent uptake might falsely underestimate lesion size or biologic activity. Alternatively, relative cerebral blood volume (rCBV) has shown promise to identify true responders. Fractional tumor burden (FTB) maps, which are derived from rCBV, allow spatially quantifiable characterization of rGBM within lesion enhancement, and therefore may provide additional value to post-treatment response-assessment. This work demonstrates that patients with less than 75% FTB following treatment with bevacizumab have a clear progression-free and overall survival benefit.
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