Advanced MRI for Brain Tumors

Overseen By Sunitha Thakur, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Memorial Sloan Kettering Cancer Center

Disqualifiers: Claustrophobia, Allergic to Gd-DTPA, Pregnant, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

135 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests advanced MRI techniques to help doctors better understand where a brain tumor might recur. Researchers hope these new imaging methods can identify high-risk areas in malignant gliomas (a type of brain tumor) and ensure the treatment remains safe with minimal side effects. Individuals diagnosed with or suspected of having a brain tumor, and who might undergo radiation therapy, may be suitable candidates for this trial. As an unphased trial, participants can contribute to pioneering research that may enhance future brain tumor treatments.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that this advanced MRI is safe for people with brain tumors?

Research has shown that advanced MRI scans are generally safe for people with brain tumors. Many studies have used these scans to help doctors better understand and classify brain tumors. Unlike some other imaging methods, they do not use radiation, making them safer.

Studies also indicate that advanced MRI can be performed without gadolinium-based contrast agents, which can sometimes cause side effects. Avoiding these agents enhances the procedure's safety.

Overall, advanced MRI is well-tolerated, and research has not reported any major side effects from these scans. This makes advanced MRI a safe option for people with brain tumors. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the advanced MRI sequences for brain tumors because these sequences offer more detailed images than standard MRI scans. Unlike conventional imaging techniques, advanced MRI can provide early insights into tumor characteristics, potentially improving surgical and radiation planning. This method allows doctors to see beyond the basic structure of the tumor, giving a clearer picture of how aggressive the tumor might be and helping tailor treatment plans more precisely to each patient.

What evidence suggests that advanced MRI is effective for brain tumors?

Research has shown that advanced MRI scans, which participants in this trial will undergo, can aid in diagnosing and understanding brain tumors, such as malignant gliomas. Studies have found that these imaging techniques, combined with machine learning, can predict patient outcomes and identify critical tumor areas. One study discovered that advanced MRI accurately detects changes in tumors, with a sensitivity rate of about 87%. This accuracy makes it particularly effective at identifying dangerous tumor parts that might recur. Advanced MRI also assists in planning treatment and monitoring disease progression. Overall, these imaging techniques hold promise for enhancing how doctors manage brain tumors. ^{1 6 7 8 9}

Who Is on the Research Team?

Robert Young, MD

Principal Investigator

Memorial Sloan Kettering Cancer Center

Are You a Good Fit for This Trial?

This trial is for adults over 18 with suspected or confirmed high or low grade gliomas, which are types of brain tumors. They should be candidates for radiation therapy and able to consent to the study. It's not suitable for those allergic to MRI contrast agents, have contraindications to MRI like pacemakers, are pregnant/nursing, can't undergo an MRI due to extreme claustrophobia, or cannot cooperate during the procedure.

Inclusion Criteria

My brain tumor is suspected to be serious or has a specific genetic change.

Patient and/or guardian is able to provide written informed consent prior to study registration

I can have radiation therapy.

Exclusion Criteria

I am not allergic or have any issues with MRI contrast dye.

I cannot undergo MRI or radiation therapy planning.

Extreme claustrophobia that precludes MRI scan

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Preoperative Planning MRI

Advanced MRI studies are obtained at the time of the routinely scheduled preoperative planning MRI

1 week

1 visit (in-person)

Pre-RT Planning MRI

Advanced MRI studies are obtained at the time of the routinely scheduled pre-RT planning MRI approximately 3±2 weeks after surgery

3 weeks

1 visit (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• MRI and advanced MRI sequences

Trial Overview

The study is testing whether advanced MR imaging techniques can more accurately identify high-risk areas in malignant gliomas that might recur after treatment. The goal is also to see if these imaging methods can help design better radiation treatment plans and monitor changes in brain tumors.

How Is the Trial Designed?

Group I: MRI Experimental Treatment 1 Intervention

The advanced MRI studies will be obtained at the time of the routinely scheduled preoperative planning MRI and/or the routinely scheduled pre-RT planning MRI at approximately 3±2 weeks after surgery. The routine sequences obtained for the planning MRI are standard of care. The advanced MRI sequences may or may not be additional as some have already been adopted into the standard of care imaging at MSKCC.

Who Is Running the Clinical Trial?

Memorial Sloan Kettering Cancer Center

Lead Sponsor

Trials

1,998

Recruited

602,000+

Published Research Related to This Trial

Advanced preoperative MRI techniques are crucial for diagnosing and planning surgery for intracranial gliomas, allowing for detailed imaging that helps assess tumor characteristics and the involvement of critical brain areas.

The use of multi-sequence MRI protocols, combined with functional mapping, enhances the ability to noninvasively grade tumors and identify functionally important brain regions, ultimately reducing the risk of functional decline during surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modern preoperative imaging and functional mapping in patients with intracranial glioma. Sollmann, N., Zhang, H., Kloth, C., et al.[2023]

Advanced MRI techniques, such as diffusion weighted imaging and MR spectroscopy, provide critical information about brain tumors that standard MRI sequences cannot, including cellularity, tumor metabolism, and vascularity.

These advanced imaging methods can enhance tumor margin identification, improve grading accuracy, reduce surgical risks, and better assess treatment responses, making them essential tools for neurosurgeons in managing brain tumors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The role of advanced MR imaging in understanding brain tumour pathology. Price, SJ.[2007]

Sodium (23Na) MRI at 7 Tesla can effectively differentiate between tumor areas in glioma patients, showing significantly higher sodium concentrations in necrotic regions compared to normal-appearing white matter, which may help in assessing tumor extent.

The study found that IDH-mutated gliomas had higher 23Na concentrations than IDH wild-type gliomas, suggesting that 23Na MRI could be a useful biomarker for tumor characterization and guiding treatment decisions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Ultra-high-field sodium MRI as biomarker for tumor extent, grade and IDH mutation status in glioma patients. Regnery, S., Behl, NGR., Platt, T., et al.[2021]

Tailored magnetic resonance fingerprinting (TMRF) can rapidly provide quantitative maps (T1, T2) and qualitative images in pediatric brain tumor patients, potentially saving about 2 minutes in imaging time.

In a study of five pediatric patients, TMRF-derived T2 weighted images showed strong correlation with standard imaging methods, indicating its effectiveness in differentiating between healthy and pathological tissues.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tailored magnetic resonance fingerprinting of post-operative pediatric brain tumor patients. Poojar, P., Qian, E., Jin, Z., et al.[2023]

Advanced MRI techniques, such as diffusion-weighted imaging and perfusion-weighted imaging, enhance the assessment of brain tumors by providing critical information on tumor characteristics like cellularity and blood volume, which are not visible with conventional MRI methods.

These advanced imaging techniques are valuable for clinical neurologists in differentiating tumor types, determining tumor grades, planning surgeries, and monitoring how well treatments are working.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Advanced MRI of adult brain tumors. Young, GS.[2022]

Magnetic resonance imaging (MRI) is a highly sensitive, noninvasive technique essential for diagnosing brain tumors and monitoring treatment responses.

Recent advancements in MRI technology allow for detailed imaging that provides insights into tissue characteristics, molecular dynamics, and vascular composition, enhancing the evaluation of brain tumors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Novel Magnetic Resonance Imaging Techniques in Brain Tumors. Nechifor, RE., Harris, RJ., Ellingson, BM.[2015]

Standard MRI techniques, including T1-weighted and T2-weighted sequences, are essential for diagnosing and managing glioblastoma, the most aggressive brain tumor, providing critical information about the tumor environment.

Advanced MRI modalities, such as dynamic contrast enhancement and diffusion tensor imaging, are being integrated into clinical practice to enhance glioblastoma characterization and support personalized treatment strategies, while also helping to minimize surgical risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Advanced magnetic resonance imaging in glioblastoma: a review. Shukla, G., Alexander, GS., Bakas, S., et al.[2018]

Recent advancements in functional MR imaging have significantly improved the clinical management of brain tumor patients by allowing direct visualization of tumor growth and its pathophysiological aspects.

The article discusses the evolution of MR imaging techniques from traditional contrast-enhanced methods to advanced functional sequences, highlighting their potential clinical applications and future developments in ultra-high-field MR imaging.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Advanced MR Imaging in Neuro-oncology. Radbruch, A., Bendszus, M.[2018]

The study found that patient-derived glioma xenografts in mice exhibited different MRI characteristics compared to the original human tumors, indicating that caution is needed when using these models for research.

Differential gene expression analysis revealed that xenografts had lower levels of genes associated with angiogenesis and immune function, which may explain the observed differences in MRI features and highlight the limitations of extrapolating data from these models to human conditions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient‑derived orthotopic xenograft glioma models fail to replicate the magnetic resonance imaging features of the original patient tumor. Xue, W., Ton, H., Zhang, J., et al.[2021]

The Glioma MR Imaging 2.0 (GliMR) network aims to enhance the use of advanced MRI techniques in glioma treatment, addressing the current limitations in clinical practice and promoting personalized treatment strategies.

Funded by the European Cooperation in Science and Technology, GliMR has initiated several projects to improve glioma imaging, including developing GDPR-compliant consent forms and creating a collaborative platform for experts, with ongoing membership opportunities until September 2023.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

GliMR: Cross-Border Collaborations to Promote Advanced MRI Biomarkers for Glioma. Clement, P., Booth, T., Borovečki, F., et al.[2022]

Advanced magnetic resonance imaging (MRI) techniques are crucial for assessing high-grade gliomas, as they provide not only detailed anatomical information but also insights into the physiological and molecular characteristics of brain tumors.

These novel imaging biomarkers can enhance the understanding of tumor burden and therapy response, potentially leading to improved patient care and treatment strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Conventional and advanced magnetic resonance imaging in patients with high-grade glioma. Pope, WB., Brandal, G.[2018]

Magnetic resonance imaging (MRI) has become essential for diagnosing and monitoring brain tumors, with volumetric growth being a key prognostic indicator.

Advanced MRI techniques, such as perfusion-weighted imaging and diffusion tensor imaging, enhance the sensitivity and specificity of brain tumor assessments, improving characterization, grading, and treatment management.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Multimodal magnetic resonance imaging of brain tumors]. Guillevin, R., Menuel, C., Vallée, JN.[2011]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10457939/

The Role of Advanced MRI Sequences in the Diagnosis and ...

The optimal MRI protocol includes both morphological and advanced sequences to diagnose brainstem gliomas, suggests the subtype of the tumor, ...

2.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC8722581/

Predicting primary outcomes of brain tumor patients with ...

This study showed that advanced neuroimaging data with machine learning methods can potentially predict patient outcomes and reveal influential ...

3.

surgicalneurologyint.com

surgicalneurologyint.com/surgicalint-articles/advanced-magnetic-resonance-imaging-for-glioblastoma-oncology-radiology-integration/

Advanced magnetic resonance imaging for glioblastoma

This study explores advanced MRI techniques better to understand GBM properties and their link to patient outcomes.

4.

sciencedirect.com

sciencedirect.com/science/article/pii/S2949761224000038

A Systematic Review and Meta-Analysis of Brain Tumors ...

The study found that the best algorithms had a pooled lesion-wise Dice score of 84%, with pooled sensitivities of 87% (patient-wise) and 86% ( ...

5.

nature.com

nature.com/articles/s41698-024-00789-2

A review of deep learning for brain tumor analysis in MRI

It facilitates objective and reproducible measurements crucial for diagnosis, treatment planning, and disease monitoring. Furthermore, it holds ...

6.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC7892735/

Advanced imaging techniques for neuro-oncologic tumor ...

This review will explore the latest in advanced imaging techniques, with a focus on the complementary nature of multiparametric, multimodality imaging.

7.

pubs.rsna.org

pubs.rsna.org/doi/full/10.1148/radiol.230793

Brain Tumor Imaging without Gadolinium-based Contrast ...

Dose reduction and clinically driven imaging are measures to reduce gadolinium-based contrast agent exposure in primary brain tumor imaging.

8.

frontiersin.org

frontiersin.org/journals/physiology/articles/10.3389/fphys.2023.1098959/full

Advanced intraoperative MRI in pediatric brain tumor surgery

This review aims to determine the added value of advanced imaging in ioMRI for pediatric brain tumor surgery compared to conventional imaging.

9.

nature.com

nature.com/articles/s41598-021-96189-8

Combining multi-site magnetic resonance imaging with ...

This study has developed a novel model of survival for pediatric brain tumors. Tumor perfusion plays a key role in determining survival.