A novel methodology for applying multivoxel mr spectroscopy to evaluate convection-enhanced drug delivery in diffuse intrinsic pontine gliomas Journal Article

   

Authors:	Guisado, D. I.; Singh, R.; Minkowitz, S.; Zhou, Z.; Haque, S.; Peck, K. K.; Young, R. J.; Tsiouris, A. J.; Souweidane, M. M.; Thakur, S. B.
Article Title:	A novel methodology for applying multivoxel mr spectroscopy to evaluate convection-enhanced drug delivery in diffuse intrinsic pontine gliomas
Abstract:	BACKGROUND AND PURPOSE: Diffuse intrinsic pontine gliomas are inoperable high-grade gliomas with a median survival of less than 1 year. Convection-enhanced delivery is a promising local drug-delivery technique that can bypass the BBB in diffuse intrinsic pontine glioma treatment. Evaluating tumor response is critical in the assessment of convection-enhanced delivery of treatment. We proposed to determine the potential of 3D multivoxel 1H-MR spectroscopy to evaluate convection-enhanced delivery treatment effect in these tumors. MATERIALS AND METHODS: We prospectively analyzed 3D multivoxel 1H-MR spectroscopy data for 6 patients with nonprogressive diffuse intrinsic pontine gliomas who received convection-enhanced delivery treatment of a therapeutic antibody (Phase I clinical trial NCT01502917). To compare changes in the metabolite ratios with time, we tracked the metabolite ratios Cho/Cr and Cho/NAA at several ROIs: normal white matter, tumor within the convection-enhanced delivery infusion site, tumor outside of the infused area, and the tumor average. RESULTS: There was a comparative decrease in both Cho/Cr and Cho/NAA metabolite ratios at the tumor convection-enhanced delivery site versus tumor outside the infused area. We used MR spectroscopy voxels with dominant white matter as a reference. The difference between changes in metabolite ratios became more prominent with increasing time after convection-enhanced delivery treatment. CONCLUSIONS: The comparative change in metabolite ratios between the convection-enhanced delivery site and the tumor site outside the infused area suggests that multivoxel 1H-MR spectroscopy, in combination with other imaging modalities, may provide a clinical tool to accurately evaluate local tumor response after convection-enhanced delivery treatment.
Keywords:	ced=convection-enhanced delivery; dipg=diffuse intrinsic pontine glioma; mrsi=mrspectroscopic imaging; postced1=1 day after ced treatment; postced2=1 month after ced treatment; postced3=2 months after ced treatment; preced=1 week prior to ced treatment
Journal Title:	American Journal of Neuroradiology
Volume:	37
Issue:	7
ISSN:	0195-6108
Publisher:	American Society of Neuroradiology
Date Published:	2016-07-01
Start Page:	1367
End Page:	1373
Language:	English
DOI:	10.3174/ajnr.A4713
PROVIDER:	scopus
PMCID:	PMC4947015
PUBMED:	26939629
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-84978531191&partnerID=40&md5=a5ac60c859f77d903bdf0defa9a5f64b
Notes:	Article -- Export Date: 2 August 2016 -- Source: Scopus

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