0 months (range, 1.3–5.0 months), with a median OS of 4.8 months (range, 1.6–14.8 months). T1 Selleck SB202190 post-contrast and flair volumetric analysis Before treatment, the volumes VT1 and VFLAIR were 27.4 ± 13.4 cm3 and 111.7 ± 53.0 cm3, respectively and at the first follow-up, were 16.1 ± 33.8 cm3 and 112.8 ± 80.9.0 cm3, respectively.

As percentages, VT1 and VFLAIR at the first follow-up relative to the initial volumes, were 59.2 ± 88.3% and 97.1 ± 70.2%, respectively, showing a decrease in VT1 and a stability of VFLAIR. Considering Selleckchem Go6983 all patients, no statistical significance appeared in either of the sequences, both in absolute units and percentages. Analysis of changes in CBV The nCBV mean, median and standard deviation (SD) within the VOI showed a strongly significant decrease during treatment, throughout the entire patient population (Table 2): the baseline values were 2.3, 2.5 and 1.6, respectively, while after the first dose of bevacizumab they were 1.2, 1.5 and 1.0, respectively.

Changes in mean and median nCBV reflect an appreciable tumor vasculature normalization because of the effect of the anti-angiogenic agent. Table 2 Results of Wilcoxon test, to establish if early changes of perfusion metrics ABT-737 are significant Summary statistics for nCBV Mean Median SD     p value 0.0006 0.0042 0.0076     Hypo-perfused sub-volumes V≤ 1.0 V≤ 0.5 V= 0     p value 0.43 0.78 0.90     Hyper-perfused sub-volumes V≥ 1.5 V≥ 2.0 V≥ 2.5 V≥ 3.0 V≥ 3.5 p value 0.0001 0.0001 ≪0.0001 ≪0.0001 ≪0.0001 Abbreviations: nCBV = normalized cerebral blood volume; SD = standard deviation;

V ≤ 1.0  = is the total number of voxels, within the volume of interest, in which nCBV is ≤ 1.0 (analogously for V≤ 0.5 and V= 0); V ≥ 1.5  = is the total number of voxels, within the volume of interest, in which nCBV is ≥ 1.5 (analogously for V≥ 2.0-V≥ 3.5). All the hyper-perfused sub-volumes (V≥ 1.5–V≥ 3.5) showed an even more significant decrease during treatment, with p values ≤ 0.0001. On the contrary, the changes of the hypo-perfused sub-volumes, including the necrotic region (V=0), were not significant (Table 2). The nCBV mean values inside 3-oxoacyl-(acyl-carrier-protein) reductase the VOI, before treatment and after a single dose of bevacizumab, are displayed for each patient in Figure 2. Baseline values have been expressly sorted in ascending order to understand whether the normalization effect of bevacizumab could somehow depend on the perfusion level of the lesion before treatment. Figure 2 Normalized cerebral blood volume for each patient. Mean values of the normalized cerebral blood volume (nCBV), before treatment and after the first dose of bevacizumab, for each patient. Correlations between early CBV changes and MRI response/PFS/OS Only the percentage change of the necrotic sub-volume (V=0), relative to the pre-treatment value, showed a significant relationship with the percentage VT1 modification at the first follow-up (correlation coefficient r = 0.829, 95% Confidence Interval = 0.551–0.