Monitoring low grade tumour progression
- Title: Making the invisible visible: In vivo mapping of molecular biomarkers in adult diffuse glioma with CEST MRI
- Lead Researchers: Professor Marion Smits
- Where: Erasmus Medical School
- When: December 2018- December 2020
- Cost: £119,250 over a 2 year period
- Research type: Adult, Low Grade, Clinical
What is it?
Previous research has shown that in parts of a tumour where the cells are multiplying rapidly, there’s a build-up of certain proteins. This project will use a new and non-invasive imaging technique called Chemical Exchange Saturation Transfer (CEST) to visualise and measure protein build-up in low grade diffuse gliomas.
The research team will then confirm their findings by comparing the images with protein measurements made from biopsies taken during surgery. This will show that the imaging technique accurately shows where the protein build-up is high and low within the tumour.
By measuring and monitoring protein build-up, researchers hope to be able to detect tumour growth and progression sooner and create more effective treatment plans.
What is CEST imaging?
MRI or Magnetic Resonance Imaging is the use of magnetic fields to build three-dimensional images of areas inside the body. But conventional MRI scans can only detect tumour growth once it has already happened.
CEST imaging is a technique that uses the same principles as conventional MRI but is made more sensitive to certain types of proteins found in the body. This sensitivity allow researchers to visualise the build-up of proteins and other substances. The ultimate goal is to see the proteins increasing before tumour growth so that doctors can predict when more aggressive treatment will be needed.
Why is it important?
Low grade diffuse gliomas are generally slow growing but have the potential to transform into faster growing, high grade brain tumours.
Currently the standard treatment for low grade diffuse tumours involves surgery, to remove as much of the tumour as possible, followed by a ’watch and wait’ policy – only starting further treatment when symptoms worsen or imaging tests, such as MRIs, show that the tumour has grown.
It’s vital that we develop more accurate ways of monitoring tumour growth in order to improve treatment plans, and ultimately improve outcomes for patients.
Who will it help?This project will help people who have been or will be diagnosed with low grade diffuse gliomas. We hope it will mean earlier identification of tumour progression and that people are given appropriate treatments faster.
My work is focused at bringing new, advanced imaging techniques into clinical practice in order to improve the diagnosis and surveillance of brain tumours. I aim to provide more certainty to the patients and treating physicians about diagnosis, prognosis, and the effect of treatment.
- Defined the settings and analysis needed to use CEST MRI in a clinical setting. The team can now use this technique to tell the difference between healthy brain tissue and tumour tissue non-invasively.
- Refine the CEST-MRI technique to allow measurement of the amount of proteins present.
- Apply this MRI technique to 20 patients with brain tumours, at Erasmus Medical Centre and Kings College London, before they undergo surgery.
- Compare the protein levels predicted by the CEST imaging to the amounts measured from brain tumour biopsies to confirm the success of the imaging technique.
The research team will optimise the imaging technique and start the recruitment of patients.