NIMG-44IMPACT OF ANGIOTENSIN-II RECEPTOR BLOCKERS ON VASOGENIC EDEMA IN GLIOBLASTOMA PATIENTS

Abstract

BACKGROUND: A significant morbidity in glioblastoma (GBM) patients is related to peri-tumoral edema, which requires chronic administration of steroids. Preliminary studies have shown that treatment with Angiotensin-II receptor blockers (ARBs) for high blood pressure might be associated with reduced peri-tumoral edema. Our goal in this study was to radiologically assess the effect of ARBs on peri-tumoral vasogenic edema. METHODS: We conducted a cross-sectional survey on patients with newly diagnosed GBM. Patients treated with ARBs for high blood pressure were paired to non ARB-treated patients, based on similar age, tumor location and longest diameter. Patients taking steroids at the time of their pre-operative Magnetic Resonance Imaging were not eligible for this study. In each pair of patients, we compared the volumes of peri-tumoral hyper T2 FLAIR signal and the apparent diffusion coefficient (ADC) selected in the same area. RESULTS: Eleven (11) patients treated with ARBs were selected and paired to 11 non ARB-treated controls. Volumes of peri-tumoral hyper T2 FLAIR signal were significantly lower in the ARB-treated group than in the non ARB-treated group (p = 0.02). Peri-tumoral ADCs were also significantly lower in the treated group (p = 0.02), suggesting that brain surrounding the tumor had less edematous characteristics when patients were treated with ARBs. CONCLUSION: All together, these results suggest that ARBs could reduce the volume of peri-tumoral hyper T2 FLAIR signal by decreasing vasogenic edema.