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Advancing imaging methods to improve surgical outcomes

Fast facts

  • Official title: Quantitative physiological imaging in glioblastoma: Moving beyond the structural boundaries
  • Lead researcher: Dr Paula Croal
  • Where: University of Nottingham
  • When: September 2020 – August 2023
  • Cost: £167,996 over three years
  • Research type: Adult, High Grade, Academic, Imaging
  • Award type: Future leaders

What is it?

Currently, surgery is the main treatment option for people who have been diagnosed with glioblastomas (GBMs). Being able to tell the difference between tumour cells (ones that surgeons want to remove) and healthy cells (ones that surgeons want to leave) is critical. Because tumour cells have a different internal structure to healthy cells, medical imaging techniques such as magnetic resonance imaging (MRI) can usually distinguish between them. This helps surgeons remove as much of the tumour as possible whilst minimising the disruption to healthy tissue.

Unfortunately, some cells may exhibit early properties of tumour cells that are beyond the detection of current MRI-based methods. These early properties could include changes to a cell’s internal processes such as pH (how acidic/alkaline the cell is) or how much blood flows to the cell. If these tumour cells aren’t detected and are therefore left behind following surgery, it can result in tumours coming back in the future.

Because of this, scientists have been advancing the MRI field by developing physiological MRI. This is an imaging technique that has the ability to detect a cell’s internal processes, alongside their internal structure. Physiological MRI has the potential to revolutionise tumour detection and maximise their removal during surgery – hopefully delaying and/or reducing tumour recurrence.

Physiological MRI is still in the early stages of development, which means it isn’t yet routinely used in hospitals. However, Dr Croal and her team are aiming to change this. By using physiological MRI to study tumour biology in people with GBM, Dr Croal hopes to identify the specific changes that occur early in brain tumours. This will help to better inform surgeons on which cells to remove during surgery.

By investigating the use of physiological MRI in people with GBM, Dr Croal also aims to develop a new automated software that is better able to analyse brain tumour images. This could help to standardise these new methods of imaging and make physiological MRI suitable for use in all hospitals.

Why is it important?

Glioblastomas are the most common form of high grade brain tumour in adults and have very poor survival rates. By advancing current imaging techniques, this could lead to improved tumour removal and surgical outcome of individuals diagnosed with GBMs in the future. As imaging is used in many stages of the treatment process, this project also has the potential to improve future diagnosis, tumour grading and the prediction/monitoring of treatment outcomes.

Imaging biological changes in glioblastoma has the potential to improve surgical resection by identifying cancerous tissue beyond the anatomical boundary of the tumour. By doing so, we aim to improve patient outcomes in terms of increased time to tumour recurrence.

Dr Paula Croal

Who will it help?

This project has the potential to improve the surgical outcome and quality of life of those who are diagnosed with GBMs in the future. As physiological MRI can also be incorporated into current imaging methods, individuals would not need any extra tests, hospital visits or specialised equipment to benefit.


We look forward to sharing the achievements of this project as it progresses.

Our thanks to Emily Conibear, an early career researcher, who volunteered her time and expertise to write this research summary.

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Dr. Paula Croal

Dr Paula Croal is an Anne McLaren Research Fellow within the Precision Imaging Beacon of Excellence at the University of Nottingham. Paula is mentored by Professor Michael Chappell.