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Abstract #1857

Anti-angiogenic therapy in recurrent glioblastoma uncouples tumor hyperperfusion measures from spectroscopic measures of Lac/c-Cr

Pratik Talati1,2, Benjamin Chun2, Patrick Clark2, Anthony Ranasinghe2, Mohamed E. El-Abtah2, Melanie Fu2, Julian He3, Otto Rapalino4, R. Gilberto Gonzalez4, Jorg Dietrich5, Elizabeth R. Gerstner5, and Eva-Maria Ratai2
1Neurosurgery, Massachusetts General Hospital, Boston, MA, United States, 2A. A. Martinos Center for Biomedical Imaging, Charlestown, MA, United States, 3Radiology, Massachusetts General Hospital, Boston, MA, United States, 4Neuroradiology, Massachusetts General Hospital, Boston, MA, United States, 5Neuro-oncology, Massachusetts General Hospital, Boston, MA, United States

Synopsis

Patients with recurrent glioblastoma (rGBM) are often started on anti-angiogenic therapy, making it challenging to determine disease progression with standard MR methods. We performed a prospective analysis on 14 patients with rGBM utilizing MR spectroscopy and DSC-perfusion imaging to investigate metabolic changes before and 4 weeks after anti-angiogenic therapy. We found that anti-angiogenic therapy significantly decreases relative tumor hyperperfusion values of CBV and CBF and uncouples a correlation between CBV and CBF with Lac/c-Cr. Baseline hyperperfusion values can stratify longer-term from shorter-term survivors at nine months. Further investigation into the early stages of anti-angiogenic therapy are warranted.

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