Meeting Banner
Abstract #0977

Reduced Diffusion and Perfusion in Bevacizumab-Induced Diffusion Restricted Necrosis Versus Brain Tumor Hypercellularity

Peter S. LaViolette1, Elizabeth Cochran2, Alexander D. Cohen3, Mona Al-Gizawiy1, Jennifer Connelley4, Scott D. Rand1, Mark G. Malkin4, Kathleen M. Schmainda1

1Radiology, Medical College of Wisconsin, Milwaukee, WI, United States; 2Pathology, Medical College of Wisconsin, Milwaukee, WI, United States; 3Biophysics, Medical College of Wisconsin, Milwaukee, WI, United States; 4Neurology, Medical College of Wisconsin, Milwaukee, WI, United States

Recent conflicting reports show that regions of bevacizumab induced restricted diffusion, as measured with DWI MRI contain neoplastic hypercellularity or atypical necrosis. In this study we look at one sample from a glioblastoma patient ex-vivo. We find that regions of dark ADC contain both hypercellularity and necrosis. Regions of necrosis had more restricted diffusion than regions of hypercallularity. rCBV was also decreased in necrotic regions compared to hypercellularity.

Keywords

accurately acquisition adjacent administered advancing apparent attention atypical autopsy axial axially began best biophysics biopsy blood brain cancer cell chemotherapy clinical college conflicting considered consisted contained containing contrast coronal correlation counts created custom days decreased define demonstrating determine devoid diagnosed diffusion dose efficacy entire equivalent eventually express expresses expressing expression extensively extraction findings fixed formalin funding gadolinium gathered generated giving grade gradient healthier highest histological histology hypercellularity in vivo individually induced injection inst instruments manually maps mark matrix measured medical microscope middle motorized natl necrosis necrotic neighboring neoplastic nuclei orientation outline outlined overlaid patient perfusion peter photo photographed photos population portions post precisely previously prior process processed processing program radiation radiology rand recent recurrence registered relate reports resolution restricted reveal sample samples sampling segmentation segmentations segmented shot significantly slice sliced slices software stage stained standardized statistical stitched studied suggest surrounding suspicious taken together toolbox trans translational treatment tumor twelve type underwent versus white