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Case Rep Radiol. 2015;2015:731361. doi: 10.1155/2015/731361. Epub 2015 Feb 22.

Assessing Biological Response to Bevacizumab Using 18F-Fluoromisonidazole PET/MR Imaging in a Patient with Recurrent Anaplastic Astrocytoma.

Author information

1
Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, M-391, San Francisco, CA 94143-0628, USA.
2
Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Room 779 M, San Francisco, CA 94143-0112, USA.
3
Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, M-391, San Francisco, CA 94143-0628, USA ; Department of Radiation Oncology, UCSF Long Hospital, 505 Parnassus Avenue, San Francisco, CA 94143-0226, USA.
4
Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Avenue, M-391, San Francisco, CA 94143-0628, USA ; Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Avenue, Room 779 M, San Francisco, CA 94143-0112, USA.

Abstract

We present our initial experience in using single modality fluoromisonidazole (FMISO) PET/MR imaging to noninvasively evaluate the biological effects induced by bevacizumab therapy in a patient treated for recurrent high grade glioma. In this index patient, bevacizumab therapy resulted in the development of nonenhancing tumor characterized by reduced diffusion and markedly decreased FMISO uptake in the setting of maintained CBF and CBV. These observations suggest that the dynamic biological interplay between tissue hypoxia and vascular normalization occurring within treated recurrent high grade glioma can be captured utilizing FMISO PET/MR imaging.

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