Radiologic response assessment during anti-angiogenic therapy of malignant glioma: a case report

This is a case report of a 62-year-old male patient diagnosed with an anaplastic astrocytoma WHO III, which was treated with anti-angiogenic therapy upon recurrence and further on developed gliomatosis cerebri. This case report demonstrates that during the course of anti-angiogenic therapy conventional MacDonalds MRI criteria are insufficient to assess tumour response. Advanced MRI sequences with MR-perfusion should be incorporated for response evaluation. 18F-FET-PET imaging may be an additional valuable tool to detect early tumour progression. At present, the value of such advanced imaging techniques is prospectively studied within the "AVIRMA trial" for patients with recurrent malignant glioma treated by Bevacizumab/Irinotecan.