PMC

Selected axial and coronal FDG-PET brain images obtained in a patient immediately before (A) and approximately 1 month after (B) SIACI therapy demonstrate a qualitative diminution of metabolic activity in the left frontal and deep thalamic lesions. The images were acquired at a 3-hour delay after radiotracer administration to increase tumor-to-background conspicuity.

Contiguous Gd-enhanced T1-weighted MR images demonstrating a marked interval decrease in the size of the enhancing component (A and B) and the associated T2-weighted/FLAIR images (C and D) of the patient’s recurrent posterior right temporal GBM before (panels A and C) and 1 month after (panels B and D) IA bevacizumab treatment.

A: Sagittal Gd-enhanced T1-weighted MR image showing a large right posterior temporal GBM (arrow). B: The microcatheter tip (arrow) adjacent to the craniotomy site on an unsubtracted digital subtraction angiography study delineates the point of chemotherapy injection. C: Digital subtraction angiogram showing contrast infusion into the distal branch of the right middle cerebral artery (arrowhead) supplying the neoplasm demonstrates the distribution of IA infusion of mannitol and bevacizumab.

Gadolinium-enhanced T1-weighted images (A and B) obtained pre- and post-IA bevacizumab infusion demonstrating a 29.6% interval decrease in the area of the targeted enhancing component of a recurrent left frontal GBM. The 3D volumetric measurements (C and D) of the targeted left frontal component (arrows) demonstrate an interval decrease of 66.8% in the volume of the neoplasm. The patient had marked clinical improvement in speech and comprehension 4 days after the procedure. Functional regional cerebral blood volume maps (E and F) on the corresponding MRP image, with regions of interest placed within the enhancing component, showing a 43% decrease in the regional cerebral blood volume values from 3.58 to 2.04 ml/100 g of brain tissue.