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

Trial Summary

What is the purpose of this trial?

The researchers think that the use of advanced MR imaging may help people with this disease, because it may better predict areas within a malignant glioma (brain tumor) that are at a high risk of recurring. WeThe reserchers are doing this study to see whether this advanced imaging is a safe treatment that causes few or mild side effects in people with brain tumors.

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 data supports the effectiveness of the treatment MRI and advanced MRI sequences for brain tumors?

Advanced MRI sequences provide more detailed information about brain tumors, such as their size, shape, and how they affect surrounding brain tissue. This helps doctors better plan surgeries and treatments, potentially improving patient outcomes by reducing surgical risks and accurately assessing the tumor's response to therapy. ^{1 2 3 4 5}

Is advanced MRI safe for use in humans?

The research does not provide specific safety data for advanced MRI, but MRI is a widely used imaging technique in clinical settings, generally considered safe for humans when standard safety guidelines are followed. ^{1 6 7 8 9}

How does advanced MRI differ from other treatments for brain tumors?

Advanced MRI is unique because it uses specialized imaging techniques to provide detailed information about brain tumors, such as their cellular structure, blood supply, and metabolism, which helps in better diagnosis, treatment planning, and monitoring compared to standard MRI. ^{1 2 10 11 12}

Research Team

Robert Young, MD

Principal Investigator

Memorial Sloan Kettering Cancer Center

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

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]

References

1. Germany pubmed.ncbi.nlm.nih.gov

Advanced MR Imaging in Neuro-oncology. [2018]

2. England pubmed.ncbi.nlm.nih.gov

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

3. Germany pubmed.ncbi.nlm.nih.gov

Modern preoperative imaging and functional mapping in patients with intracranial glioma. [2023]

4. France pubmed.ncbi.nlm.nih.gov

[Multimodal magnetic resonance imaging of brain tumors]. [2011]

5. Italy pubmed.ncbi.nlm.nih.gov

Conventional and advanced magnetic resonance imaging in patients with high-grade glioma. [2018]

6. United States pubmed.ncbi.nlm.nih.gov

Tailored magnetic resonance fingerprinting of post-operative pediatric brain tumor patients. [2023]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Ultra-high-field sodium MRI as biomarker for tumor extent, grade and IDH mutation status in glioma patients. [2021]

8. China pubmed.ncbi.nlm.nih.gov

GliMR: Cross-Border Collaborations to Promote Advanced MRI Biomarkers for Glioma. [2022]

9. Greece pubmed.ncbi.nlm.nih.gov

Patient‑derived orthotopic xenograft glioma models fail to replicate the magnetic resonance imaging features of the original patient tumor. [2021]

10. China pubmed.ncbi.nlm.nih.gov

Advanced magnetic resonance imaging in glioblastoma: a review. [2018]

11. United States pubmed.ncbi.nlm.nih.gov

Advanced MRI of adult brain tumors. [2022]

12. United States pubmed.ncbi.nlm.nih.gov

Novel Magnetic Resonance Imaging Techniques in Brain Tumors. [2015]