December 2012


The Relationship Between Imaging Biomarkers, Histology, Gene Expression, and Survival in Primary Glial Tumors

Pamela Schaefer

During the last decade we have seen marked progress in brain tumor imaging. With the development of advanced MRI techniques, we have moved from anatomic to physiologic imaging of brain tumors. For example, perfusion MRI has allowed determination of tumor grade and differentiation of recurrent tumor from necrosis with elevated cerebral blood volume correlating with neovascularity. MR spectroscopy has allowed … more »


Survival Analysis of Patients with High-Grade Gliomas Based on Data Mining of Imaging Variables

Evangelia I. Zacharaki

High-grade brain gliomas have a terrible prognosis, with mean survival just over one year even though combinations of surgical removal, radiotherapy, and chemotherapy are used in clinical practice. Our overarching hypothesis is that advanced modeling and analysis methods, which combine diverse information from patient multiparametric images, tumor histologic and molecular profile, biophysical models of glioma growth, and population-based statistics, will … more »


Metabolic Response of Glioblastoma to Superselective Intra-Arterial Cerebral Infusion of Bevacizumab: A Proton MR Spectroscopic Imaging Study

Apostolos J. Tsiouris

Bevacizumab is a monoclonal antibody that is now routinely administered intravenously for the treatment of recurrent glioblastomas, and is thought to inhibit vascular endothelial growth factor (VEGF) and therefore angiogenesis. There has been extensive debate in the literature as to the histopathologic effects of bevacizumab on glioblastomas. How to best determine response with imaging is also currently a very … more »


Probabilistic Radiographic Atlas of Glioblastoma Phenotypes

Benjamin M. Ellingson

Investigators from our team recently discovered that patients with glioma having mutation of the isocitrate dehydrogenase-1 (IDH1) gene tended to have larger, nonenhancing tumors localized in the frontal lobe (Lai et al, J Clin Oncol, 2011; 29:4482-90). Using an approach similar to lesion-symptom mapping, we developed a technique where MR images of the brains of patients with glioma were registered to … more »


Isolated Diffusion Restriction Precedes the Development of Enhancing Tumor in a Subset of Patients with Glioblastoma

Ajay Gupta

Robert J. Young

In this article, we investigated the utility of diffusion-weighted imaging in monitoring patients being treated for glioblastoma. We found that some treated glioblastomas developed diffusion-restricted nonenhancing lesions that subsequently transformed into enhancing lesions. We concluded that these quantitative decreases on apparent diffusion coefficient maps were probably related to increasing tumor … more »


Application of 62Cu-Diacetyl-Bis (N4-Methylthiosemicarbazone) PET Imaging to Predict Highly Malignant Tumor Grades and Hypoxia-Inducible Factor-1α Expression in Patients with Glioma

Kensuke Tateishi

Nobutaka Kawahara

Tissue hypoxia is a typical feature of highly malignant tumors, and glioblastoma, the most malignant tumor in the central nervous system, is not an exception. Indeed, glioblastomas are characterized by necrotic regions that distinguish them from less malignant gliomas. In addition, treatment-resistant cancer stem cell–like cells are supposed to … more »


Correlations between Perfusion MR Imaging Cerebral Blood Volume, Microvessel Quantification, and Clinical Outcome Using Stereotactic Analysis in Recurrent High-Grade Glioma

Leland S. Hu

MRI biomarkers have the potential to greatly impact glioma care.  However, the medical community has been slow to adopt these, in part, because we don’t yet fully understand their basic relationships with histologic correlates.

For instance, we have long assumed that pMRI measurements (ie, relative cerebral blood volume, rCBV) correspond highly with histologic quantification of microvessel number (ie, microvessel density, … more »


Correlation of Perfusion Parameters with Genes Related to Angiogenesis Regulation in Glioblastoma: A Feasibility Study

Rajan Jain

Recent improvements in determining molecular/genomic expression of any tissue have brought us one step closer to personalized treatment for many disease processes, notably in oncology. This could be especially true for glioblastomas as the currently available treatment options have not improved the dismal survival. One of the major reasons for this is that current treatment approaches don’t have sufficiently specific molecular targets. … more »