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:
Notes: Article -- Export Date: 2 August 2016 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Robert J Young
    122 Young
  2. Sofia S Haque
    90 Haque
  3. Kyung Peck
    82 Peck
  4. Sunitha Bai Thakur
    49 Thakur