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Fig. 1D —62-year-old man with glioblastoma multiforme. Depiction of
changes in leakage of contrast material (a reflection of degree of
permeability across blood-brain barrier) after administration of
antiangiogenic agent directed against vascular endothelial growth factor
(VEGF) receptor tyrosine kinase. Series of images shows additional physiologic
information provided by dynamic imaging relative to solely anatomic
information provided by conventional MRI. Because imaging findings solely
reflect effect of angiogenesis (i.e., permeability), this technique is an
example of indirect imaging of angiogenesis. Color-coded map derived from
dynamic contrast-enhanced imaging sequence obtained 30 days after initiation
of therapy (corresponding to C) shows moderate decrease in total number
of color-coded pixels but, importantly, marked decrease in number of pixels at
middle and high end of contrast leakage range (green and red
pixels). Changes in degree of leakage of contrast material (reflecting changes
in degree of permeability) can be substantially greater than changes in
enhancing tumor size.
