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Avastin Scintigraphy in Surveillance of Bevacizumab Treatment in a Patient With Neurofibromatosis Type 2: A Case Report

Versleijen, Michelle W.J. MD*; Verbist, Berit M. MD; Mulder, Jef J.S. MD; de Geus-Oei, Lioe-Fee MD*; van Herpen, Carla M.L. MD§

doi: 10.1097/RLU.0000000000000329
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A patient with neurofibromatosis type 2 (bilateral vestibular schwannomas) was treated with bevacizumab (anti-vascular endothelial growth factor [VEFG] monoclonal antibody). The left-sided tumor showed intense uptake on pretreatment 111In-bevacizumab scintigraphy, indicating VEGF production in the tumor, and no uptake 4 weeks later, demonstrating effective binding of nonradiolabeled bevacizumab to the VEGF produced in the tumor. The right-sided tumor showed no tracer uptake at any time point. Significant tumor volume reduction (assessed with MRI) and hearing improvement were observed on the left side. 111In-bevacizumab scintigraphy may be a promising upfront patient selection tool to identify patients who may benefit from expensive bevacizumab treatment.

From the Departments of *Nuclear Medicine, †Radiology, ‡Ear Nose and Throat, and §Medical Oncology, Radboud University Medical Centre, Nijmegen, the Netherlands.

Received for publication April 3, 2013; revision accepted November 11, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Michelle W.J. Versleijen, MD, MSc, PhD, Radboud University Medical Centre, Nijmegen, Department of Nuclear Medicine, Route 757, Geert Grooteplein 10, 6525 GA Nijmegen, the Netherlands. E-mail:

© 2014 by Lippincott Williams & Wilkins