Evidence map›Paper›PMID 34751617›Full record

ArticleRadiology2022

Myo-Inositol Levels Measured with MR Spectroscopy Can Help Predict Failure of Antiangiogenic Treatment in Recurrent Glioblastoma.

Mohamed E El-Abtah, Michael R Wenke, Pratik Talati, Melanie Fu, Daniel Kim, Akila Weerasekera, Julian He, Anna Vaynrub, Mark Vangel, Otto Rapalino and 10 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02843230 (Monitoring Anti-angiogenic Therapy in Brain Tumors by Advanced MRI), which is not on this map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.8field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02843230 completednot on this map

Monitoring Anti-angiogenic Therapy in Brain Tumors by Advanced MRI

TypeobservationalSponsorMassachusetts General HospitalRan2016 to 2022Enrolled30ConditionsGlioblastomaArmsAvastin, Lomustine, Temozolomide, MRI, MRS
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 17 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors at 2 institutions in 1 country.

Mohamed E El-Abtah *From the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0001-8451-7012
Michael R Wenke *From the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-2491-2296
Pratik TalatiFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-3420-5157
Melanie FuFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0001-5682-6432
Daniel KimFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-9390-672X
Akila WeerasekeraFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).
Julian HeFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-4779-1538
Anna VaynrubFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-8544-1758
Mark VangelFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0003-2993-2365
Otto RapalinoFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-5038-4183
Ovidiu AndronesiFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).
Isabel Arrillaga-RomanyFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0001-5951-1225
Deborah A ForstFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-8428-0841
Yi-Fen YenFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).
Bruce RosenFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-8576-0839
Tracy T BatchelorFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0001-7568-6607
R Gilberto GonzalezFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0002-0234-3897
Jorg DietrichFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0001-8291-0136
Elizabeth R GerstnerFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0003-2382-3838
Eva-Maria RataiFrom the Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Neuroradiology Division (M.E.E., M.R.W., M.F., D.K., A.W., J.H., A.V., M.V., O.R., O.A., Y.F.Y., B.R., R.G.G., E.M.R.), and Department of Neurosurgery (P.T.), Massachusetts General Hospital, Harvard Medical School, Building 149, 13th St, Room 2301, Charlestown, MA 02129; and Massachusetts General Hospital Cancer Center, Boston, Mass (I.A.R., D.A.F., T.T.B., J.D., E.R.G.).ORCID 0000-0001-9476-6207
Harvard University · USMassachusetts General Hospital · US

Funding

AZD2171 and chemoradiation for newly diagnosed glioblastomaR01CA129371 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI BATCHELOR, TRACY T · 2007 to 2017
$6.2M
SILICON GRAPHICS PRISM EXTREME 128P/1TBS10RR023043 · NCRR · MASSACHUSETTS GENERAL HOSPITAL · PI SORENSEN, ALMA GREGORY · 2006 to 2006
$1.5M
Identifying Early Failure to Anti-angiogenic Therapy in Recurrent GBMR01CA190901 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI RATAI, EVA-MARIA · 2015 to 2018
$1.4M
Evaluation of impact of anti-VEGF drugs on concomitant chemotherapy in GBMK23CA169021 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI GERSTNER, ELIZABETH · 2014 to 2018
$896k
Exploring the Relationship Between Tau Deposition and Neurovascular Health in Alzheimer's DiseaseR21AG067562 · NIA · MASSACHUSETTS GENERAL HOSPITAL · PI HUANG, SUSIE YI, YEN, YI-FEN · 2020 to 2020
$462k
A Proof-of-concept of Vitamin B3 for Metabolic MR ImagingR21GM137227 · NIGMS · MASSACHUSETTS GENERAL HOSPITAL · PI YEN, YI-FEN · 2020 to 2021
$461k
NCI NIH HHS K23 CA169021NCI NIH HHS R01 CA129371NCI NIH HHS R01 CA190901NCRR NIH HHS S10 RR023043NIA NIH HHS R21 AG067562NIGMS NIH HHS R21 GM137227
6 · The paper itself

Abstract

Background Patients with recurrent glioblastoma (GBM) are often treated with antiangiogenic agents, such as bevacizumab (BEV). Despite therapeutic promise, conventional MRI methods fail to help determine which patients may not benefit from this treatment. Purpose To use MR spectroscopic imaging (MRSI) with intermediate and short echo time to measure corrected myo-inositol (mI)normalized by contralateral creatine (hereafter, mI/c-Cr) in participants with recurrent GBM treated with BEV and to investigate whether such measurements can help predict survivorship before BEV initiation (baseline) and at 1 day, 4 weeks, and 8 weeks thereafter. Materials and Methods In this prospective longitudinal study (2016-2020), spectroscopic data on mI-a glial marker and osmoregulator within the brain-normalized by contralateral creatine in the intratumoral, contralateral, and peritumoral volumes of patients with recurrent GBM were evaluated. Area under the receiver operating characteristic curve (AUC) was calculated for all volumes at baseline and 1 day, 4 weeks, and 8 weeks after treatment to determine the ability of mI/c-Cr to help predict survivorship. Results Twenty-one participants (median age ± standard deviation, 62 years ± 12; 15 men) were evaluated. Lower mI/c-Cr in the tumor before and during BEV treatment was predictive of poor survivorship, with receiver operating characteristic analyses showing an AUC of 0.75 at baseline, 0.87 at 1 day after treatment, and 1 at 8 weeks after. A similar result was observed in contralateral normal-appearing tissue and the peritumoral volume, with shorter-term survivors having lower levels of mI/c-Cr. In the contralateral volume, a lower ratio of mI to creatine (hereafter, mI/Cr) predicted shorter-term survival at baseline and all other time points. Within the peritumoral volume, lower mI/c-Cr levels were predictive of shorter-term survival at baseline (AUC, 0.80), at 1 day after treatment (AUC, 0.93), and at 4 weeks after treatment (AUC, 0.68). Conclusion Lower levels of myo-inositol normalized by contralateral creatine within intratumoral, contralateral, and peritumoral volumes were predictive of poor survivorship and antiangiogenic treatment failure as early as before bevacizumab treatment. Adapting MR spectroscopic imaging alongside conventional MRI modalities conveys critical information regarding the biologic characteristics of tumors to help better treat individuals with recurrent glioblastoma. Clinical trial registration no. NCT02843230 © RSNA, 2021

Indexed as

Angiogenesis InhibitorsBevacizumabBiomarkers, TumorBrain NeoplasmsFemaleGlioblastomaHumansInositolLongitudinal StudiesMagnetic Resonance SpectroscopyMaleMiddle AgedNeoplasm Recurrence, LocalPredictive Value of TestsProspective StudiesTreatment FailureAngiogenesis InhibitorsBevacizumabBiomarkers, TumorInositol

Identifiers

PMID34751617
PMCPMC8805659
OpenAlexW3213102076

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.