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Dynamic contrast-enhanced T1-weighted magnetic resonance imaging (DCE-MRI) is being increasingly used in various clinical trials involving brain tumors. It allows characterization of the vascular microenvironment in tumors by measurement of a range of parameters, such as Ktrans (forward transfer constant), kep (reverse transfer constant), ve (volume of the extravascular extracellular space), and vp (blood plasma volume) (1,2). These parameters reflect specific physiologic characteristics and hence relate to various aspects of tumor biology. One of the hurdles in obtaining these quantitative metrics is a lack of robust methods for approaching the problem of parametric estimation using multicompartmental pharmacokinetic models (3). Another issue is that current Food and Drug Administration (FDA)-approved extravascular contrast agents (CAs) used for the assessment of vascular parameters in solid tumors are relatively small (molecular weight

The aim of the study was to determine the antiangiogenic efficacy of vatalanib, sunitinib, and AMD3100 in an animal model of human glioblastoma (GBM) by using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and tumor protein expression analysis. Orthotopic GBM-bearing animals were randomly assigned either to control group or vatalanib, sunitinib, and AMD3100 treatment groups. Following 2 weeks of drug treatment, tumor growth and vascular parameters were measured using DCE-MRI. Expression of different angiogenic factors in tumor extracts was measured using a membrane-based human antibody array kit. Tumor angiogenesis and invasion were determined by immunohistochemistry. DCE-MRI showed a significant increase in tumor size after vatalanib treatment. AMD3100-treated group showed a significant decrease in a number of vascular parameters determined by DCE-MRI. AMD3100 significantly decreased the expression of different angiogenic factors compared to sunitinib or vatalanib; however, there were no significant changes in vascular density among the groups. Sunitinib-treated animals showed significantly higher migration of the invasive cells, whereas in both vatalanib- and AMD3100-treated animals the invasive cell migration distance was significantly lower compared to that of control. Vatalanib and sunitinib resulted in suboptimal therapeutic effect, but AMD3100 treatment resulted in a significant reduction in tumor growth, permeability, interstitial space volume, and invasion of tumor cells in an animal model of GBM.

Glioblastoma (GBM) is a hypervascular primary brain tumor with poor prognosis. HET0016 is a selective CYP450 inhibitor, which has been shown to inhibit angiogenesis and tumor growth. Therefore, to explore novel treatments, we have generated an improved intravenous (IV) formulation of HET0016 with HPßCD and tested in animal models of human and syngeneic GBM. Administration of a single IV dose resulted in 7-fold higher levels of HET0016 in plasma and 3.6-fold higher levels in tumor at 60 min than that in IP route. IV treatment with HPßCD-HET0016 decreased tumor growth, and altered vascular kinetics in early and late treatment groups (p

We present a case report of a 72-year-old man with an anomalous lobar pulmonary vein which was initially misdiagnosed as a pulmonary arteriovenous malformation on chest computed tomography. This uncommon condition was correctly diagnosed during pulmonary angiography performed as workup for the computed tomography finding. In this report, we describe the imaging findings in this case and discuss congenital anomalies of the pulmonary veins.

Adarsh Shankar,1 Thaiz F Borin,2 Asm Iskander,1 Nadimpalli RS Varma,3 Bhagelu R Achyut,1 Meenu Jain,1 Tom Mikkelsen,4 Austin M Guo,5 Wilson B Chwang,3 James R Ewing,6 Hassan Bagher-Ebadian,6Ali S Arbab11Tumor Angiogenesis Laboratory, Cancer Center, Georgia Regents University, Augusta, GA, USA; 2Laboratory of Molecular Investigation of Cancer (LIMC), Faculty of Medicine of Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil; 3Department of Radiology, Cellular and Molecular Imaging Laboratory, 4Department of Neurosurgery, Henry Ford Health System, Detroit, MI, 5Department of Pharmacology, New York Medical College, Valhalla, NY, 6Department of Neurology and Radiology, Henry Ford Health System, Detroit, MI, USA Background: Due to the hypervascular nature of glioblastoma (GBM), antiangiogenic treatments, such as vatalanib, have been added as an adjuvant to control angiogenesis and tumor growth. However, evidence of progressive tumor growth and resistance to antiangiogenic treatment has been observed. To counter the unwanted effect of vatalanib on GBM growth, we have added a new agent known as N-hydroxy-N'-(4-butyl-2 methylphenyl)formamidine (HET0016), which is a selective inhibitor of 20-hydroxyeicosatetraenoic acid (20-HETE) synthesis. The aims of the studies were to determine 1) whether the addition of HET0016 can attenuate the unwanted effect of vatalanib on tumor growth and 2) whether the treatment schedule would have a crucial impact on controlling GBM.Methods: U251 human glioma cells (4×105) were implanted orthotopically. Two different treatment schedules were investigated. Treatment starting on day 8 (8–21days treatment) of the tumor implantation was to mimic treatment following detection of tumor, where tumor would have hypoxic microenvironment and well-developed neovascularization. Drug treatment starting on the same day of tumor implantation (0–21days treatment) was to mimic cases following radiation therapy or surgery. There were four different treatment groups: vehicle, vatalanib (oral treatment 50mg/kg/d), HET0016 (intraperitoneal treatment 10mg/kg/d), and combined (vatalanib and HET0016). Following scheduled treatments, all animals underwent magnetic resonance imaging on day 22, followed by euthanasia. Brain specimens were equally divided for immunohistochemistry and protein array analysis.Results: Our results demonstrated a trend that HET0016, alone or in combination with vatalanib, is capable of controlling the tumor growth compared with that of vatalanib alone, indicating attenuation of the unwanted effect of vatalanib. When both vatalanib and HET0016 were administered together on the day of the tumor implantation (0–21days treatment), tumor volume, tumor blood volume, permeability, extravascular and extracellular space volume, tumor cell proliferation, and cell migration were decreased compared with that of the vehicle-treated group. Conclusion: HET0016 is capable of controlling tumor growth and migration, but these effects are dependent on the timing of drug administration. The addition of HET0016 to vatalanib may attenuate the unwanted effect of vatalanib.Keywords: magnetic resonance imaging, glioblastoma, antiangiogenic treatments, HET0016, vascular parameters, protein array

C holesterol granulomas are commonly found in the petrous apex. Patients with cholesterol granulomas may present with headache or symptoms related to mass effect on adjacent structures and cranial nerves, and cholesterol granulomas often may be an incidental finding on neuroimaging for other reasons. Although these lesions may remain dormant for many years, they can also suddenly enlarge, with expansion and subsequent remodeling of the petrous apex. The most common explanation for expansion or enlargement of cholesterol granuloma is thought to be internal hemorrhage. The ability to identify cholesterol granuloma is crucial, since in the acute setting it can simulate an enlarging aggressive lesion.

Inflammatory pseudotumor of the nasopharynx and skull base is a benign, idiopathic disease that is often mistaken for a neoplasm or infection owing to its aggressive behavior and clinical presentation. It can present as a progressively destructive mass and should be considered when repeated tissue biopsies reveal acute or chronic inflammation without evidence of malignant disease or infection. We present 4 cases of nasopharyngeal inflammatory pseudotumor with skull base invasion occurring in patients with diabetes mellitus (DM). These patients had repeated negative results from biopsies and cultures, and none had associated cervical lymphadenopathy despite having an aggressive destructive mass. We suggest that these findings, coupled with clinical suspicion, will be helpful in making the correct diagnosis of inflammatory pseudotumor. This is critical in the management of these patients to institute the correct treatment plan.