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<meta name="DC.Title" content="MR Imaging and Single-Photon Emission CT Findings after Gene Therapy for Human Glioblastoma" />
<meta name="DC.Date" content="2001-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Our goal was to evaluate MR imaging findings after local intracerebral gene therapy in patients with glioblastoma and differentiate postoperative contrast enhancement phenomena.

METHODS: In all, 26 patients with supratentorial single lesion glioblastoma underwent tumor resection and intracerebral injection of murine retroviral vector–producer cells for gene therapy with the herpes simplex virus type I thymidine kinase gene/ganciclovir system. Serial contrast-enhanced MR studies were obtained before treatment and postoperatively on day 1 or 2; weeks 2, 4, 9, 13, 17, 25, and 33; and every 8 weeks thereafter. Iodomethyltyrosine single-photon emission CT (IMT-SPECT) investigations also were performed in selected cases.

RESULTS: Twelve patients showed nontumorous enhancement of various intensities after treatment, arising within 18 to 72 hours and persisting at 3 to 10 months. It was characterized by a strong local enhancement up to 20 mm thick, which was initially nodular and later linear along the resection cavity wall and surrounded by massive perifocal edema. This “flare” enhancement had features that clearly differed from those of residual tumor enhancements and benign postsurgical enhancements. The IMT-SPECT investigations showed increased amino acid uptake in patients with enhancement from residual or relapsing tumor, but not in patients with flare.

CONCLUSION: After local gene therapy, a unique dynamic, transient perifocal flare enhancement can occur on MR images. IMT-SPECT may help to differentiate between tumorous and nontumorous flare enhancements in patients with enhancing tissue on MR images after gene therapy for glioblastoma." />
<meta name="DC.Contributor" content="Frank W. Floeth" />
<meta name="DC.Contributor" content="Albrecht Aulich" />
<meta name="DC.Contributor" content="Karl J. Langen" />
<meta name="DC.Contributor" content="Klaus J. Burger" />
<meta name="DC.Contributor" content="Wolfgang J. Bock" />
<meta name="DC.Contributor" content="Friedrich Weber" />
<meta name="article:published_time" content="2001-09-01" />
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<meta name="citation_title" content="MR Imaging and Single-Photon Emission CT Findings after Gene Therapy for Human Glioblastoma" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;i&gt;BACKGROUND AND PURPOSE:&lt;/i&gt; Our goal was to evaluate MR imaging findings after local intracerebral gene therapy in patients with glioblastoma and differentiate postoperative contrast enhancement phenomena.&lt;/p&gt;&lt;p&gt;&lt;i&gt;METHODS:&lt;/i&gt; In all, 26 patients with supratentorial single lesion glioblastoma underwent tumor resection and intracerebral injection of murine retroviral vector–producer cells for gene therapy with the herpes simplex virus type I thymidine kinase gene/ganciclovir system. Serial contrast-enhanced MR studies were obtained before treatment and postoperatively on day 1 or 2; weeks 2, 4, 9, 13, 17, 25, and 33; and every 8 weeks thereafter. Iodomethyltyrosine single-photon emission CT (IMT-SPECT) investigations also were performed in selected cases.&lt;/p&gt;&lt;p&gt;&lt;i&gt;RESULTS:&lt;/i&gt; Twelve patients showed nontumorous enhancement of various intensities after treatment, arising within 18 to 72 hours and persisting at 3 to 10 months. It was characterized by a strong local enhancement up to 20 mm thick, which was initially nodular and later linear along the resection cavity wall and surrounded by massive perifocal edema. This “flare” enhancement had features that clearly differed from those of residual tumor enhancements and benign postsurgical enhancements. The IMT-SPECT investigations showed increased amino acid uptake in patients with enhancement from residual or relapsing tumor, but not in patients with flare.&lt;/p&gt;&lt;p&gt;&lt;i&gt;CONCLUSION:&lt;/i&gt; After local gene therapy, a unique dynamic, transient perifocal flare enhancement can occur on MR images. IMT-SPECT may help to differentiate between tumorous and nontumorous flare enhancements in patients with enhancing tissue on MR images after gene therapy for glioblastoma.&lt;/p&gt;" />
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<meta name="twitter:title" content="MR Imaging and Single-Photon Emission CT Findings after Gene Therapy for Human Glioblastoma" />
<meta name="twitter:card" content="summary_large_image" />
<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/22/8.cover.gif" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Our goal was to evaluate MR imaging findings after local intracerebral gene therapy in patients with glioblastoma and differentiate postoperative contrast enhancement phenomena.

METHODS: In all, 26 patients with supratentorial single lesion glioblastoma underwent tumor resection and intracerebral injection of murine retroviral vector–producer cells for gene therapy with the herpes simplex virus type I thymidine kinase gene/ganciclovir system. Serial contrast-enhanced MR studies were obtained before treatment and postoperatively on day 1 or 2; weeks 2, 4, 9, 13, 17, 25, and 33; and every 8 weeks thereafter. Iodomethyltyrosine single-photon emission CT (IMT-SPECT) investigations also were performed in selected cases.

RESULTS: Twelve patients showed nontumorous enhancement of various intensities after treatment, arising within 18 to 72 hours and persisting at 3 to 10 months. It was characterized by a strong local enhancement up to 20 mm thick, which was initially nodular and later linear along the resection cavity wall and surrounded by massive perifocal edema. This “flare” enhancement had features that clearly differed from those of residual tumor enhancements and benign postsurgical enhancements. The IMT-SPECT investigations showed increased amino acid uptake in patients with enhancement from residual or relapsing tumor, but not in patients with flare.

CONCLUSION: After local gene therapy, a unique dynamic, transient perifocal flare enhancement can occur on MR images. IMT-SPECT may help to differentiate between tumorous and nontumorous flare enhancements in patients with enhancing tissue on MR images after gene therapy for glioblastoma." />
<meta name="og-title" property="og:title" content="MR Imaging and Single-Photon Emission CT Findings after Gene Therapy for Human Glioblastoma" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/22/8/1517" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Our goal was to evaluate MR imaging findings after local intracerebral gene therapy in patients with glioblastoma and differentiate postoperative contrast enhancement phenomena.

METHODS: In all, 26 patients with supratentorial single lesion glioblastoma underwent tumor resection and intracerebral injection of murine retroviral vector–producer cells for gene therapy with the herpes simplex virus type I thymidine kinase gene/ganciclovir system. Serial contrast-enhanced MR studies were obtained before treatment and postoperatively on day 1 or 2; weeks 2, 4, 9, 13, 17, 25, and 33; and every 8 weeks thereafter. Iodomethyltyrosine single-photon emission CT (IMT-SPECT) investigations also were performed in selected cases.

RESULTS: Twelve patients showed nontumorous enhancement of various intensities after treatment, arising within 18 to 72 hours and persisting at 3 to 10 months. It was characterized by a strong local enhancement up to 20 mm thick, which was initially nodular and later linear along the resection cavity wall and surrounded by massive perifocal edema. This “flare” enhancement had features that clearly differed from those of residual tumor enhancements and benign postsurgical enhancements. The IMT-SPECT investigations showed increased amino acid uptake in patients with enhancement from residual or relapsing tumor, but not in patients with flare.

CONCLUSION: After local gene therapy, a unique dynamic, transient perifocal flare enhancement can occur on MR images. IMT-SPECT may help to differentiate between tumorous and nontumorous flare enhancements in patients with enhancing tissue on MR images after gene therapy for glioblastoma." />
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      <h1 class="highwire-cite-title" id="page-title">MR Imaging and Single-Photon Emission CT Findings after Gene Therapy for Human Glioblastoma</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Frank W. Floeth</span>, <span class="highwire-citation-author" data-delta="1">Albrecht Aulich</span>, <span class="highwire-citation-author" data-delta="2">Karl J. Langen</span>, <span class="highwire-citation-author" data-delta="3">Klaus J. Burger</span>, <span class="highwire-citation-author" data-delta="4">Wolfgang J. Bock</span> and <span class="highwire-citation-author" data-delta="5">Friedrich Weber</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2001,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">22 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1517-1527; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-2766--61030357434" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Frank W. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list"><li><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1 in text" id="ref-1">↵</a><div class="cit ref-cit ref-other" id="cit-22.8.1517.1" data-doi="10.1159/000083943"><div class="cit-metadata"><cite>Davis FG, Malinski N, Haenszel W,  et al.  <strong>Primary brain tumor incidence rates in four United States regions, 1985–1989: a pilot study.</strong> <span class="cit-source">Neuroepidemiology</span> <span class="cit-pub-date">1996</span>;<span class="cit-vol">15</span>:<span class="cit-fpage">103</span>-112</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1159/000083943&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a 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glial tumors: a multicenter study.</strong> <span class="cit-source">J Neurosurg</span> <span class="cit-pub-date">1996</span>;<span class="cit-vol">84</span>:<span class="cit-fpage">449</span>-458</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.3171/jns.1996.84.3.0449&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=8609557&amp;link_type=MED&amp;atom=%2Fajnr%2F22%2F8%2F1517.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=A1996TW71300012&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><div class="cit ref-cit ref-other no-rev-xref" id="cit-22.8.1517.30"><div class="cit-metadata"><cite>Poptani H, Gupta RK, Roy R,  et al.  <strong>Characterization of intracranial mass lesions with in vivo proton MR spectroscopy.</strong> <span class="cit-source">AJNR Am J Neuroradiol</span> <span class="cit-pub-date">1995</span>;<span class="cit-vol">16</span>:<span class="cit-fpage">1593</span>-1603</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czo5OiIxNi84LzE1OTMiO3M6NDoiYXRvbSI7czoyMDoiL2FqbnIvMjIvOC8xNTE3LmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span></span></a></div></div></li><li><div class="cit ref-cit ref-other no-rev-xref" id="cit-22.8.1517.31"><div class="cit-metadata"><cite>Michaelis T, Merboldt KD, Bruhn H,  et al.  <strong>Absolute concentrations of metabolites in the adult human brain in vivo: quantification of localized proton MR spectra.</strong> <span class="cit-source">Radiology</span> <span class="cit-pub-date">1993</span>;<span class="cit-vol">187</span>:<span class="cit-fpage">219</span>-227</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=8451417&amp;link_type=MED&amp;atom=%2Fajnr%2F22%2F8%2F1517.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=A1993KT24400043&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-32-1" title="View reference 32 in text" id="ref-32">↵</a><div class="cit ref-cit ref-other" id="cit-22.8.1517.32"><div class="cit-metadata"><cite>Fulham MJ, Bizzi A, Dietz MJ,  et al.  <strong>Mapping of brain tumor metabolites with proton MR spectroscopic imaging: clinical relevance.</strong> <span class="cit-source">Radiology</span> <span class="cit-pub-date">1992</span>;<span class="cit-vol">185</span>:<span class="cit-fpage">675</span>-686</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=1438744&amp;link_type=MED&amp;atom=%2Fajnr%2F22%2F8%2F1517.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-33-1" title="View reference 33 in text" id="ref-33">↵</a><div class="cit ref-cit ref-other" id="cit-22.8.1517.33"><div class="cit-metadata"><cite>Langen K-J, Coenen HH, Roosen N,  et al.  <strong>SPECT studies of brain tumors with L-3-[<sup>123</sup>I]Iodo-α-methyl tyrosine: comparison with PET, <sup>124</sup>IMT and first clinical results.</strong> <span class="cit-source">J Nucl Med</span> <span class="cit-pub-date">1990</span>;<span class="cit-vol">31</span>:<span class="cit-fpage">281</span>-286</cite></div><div class="cit-extra"><a 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<span class="cit-pub-date">1996</span>;<span class="cit-vol">23</span>:<span class="cit-fpage">1345</span>-1353</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1007/BF01367590&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=8781139&amp;link_type=MED&amp;atom=%2Fajnr%2F22%2F8%2F1517.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-35-1" title="View reference 35 in text" id="ref-35">↵</a><div class="cit ref-cit ref-other" id="cit-22.8.1517.35" data-doi="10.1016/S0360-3016(00)00423-5"><div class="cit-metadata"><cite>Grosu AL, Weber W, Feldmann HJ,  et al.  <strong>First experience with I-123-alpha-methyl-tyrosine SPECT in the 3-D radiation treatment planning of brain gliomas.</strong> <span class="cit-source">Int J Radiat Oncol Biol Phys</span> <span 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 22</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 8 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Sep 2001 </div></div>
      
      
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Frank W.</span> <span class="nlm-surname">Floeth</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Albrecht</span> <span class="nlm-surname">Aulich</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Karl J.</span> <span class="nlm-surname">Langen</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Klaus J.</span> <span class="nlm-surname">Burger</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Wolfgang J.</span> <span class="nlm-surname">Bock</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Friedrich</span> <span class="nlm-surname">Weber</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2001, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">22 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1517-1527; </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Frank W.</span> <span class="nlm-surname">Floeth</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Albrecht</span> <span class="nlm-surname">Aulich</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">Karl J.</span> <span class="nlm-surname">Langen</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Klaus J.</span> <span class="nlm-surname">Burger</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Wolfgang J.</span> <span class="nlm-surname">Bock</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">Friedrich</span> <span class="nlm-surname">Weber</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2001, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">22 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(8) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1517-1527; </span></div>
  
  
  
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