Symptoms and General Pathology

All Conditions

Neoplasms

Rare Diseases

Recurrence

Glioblastoma

Glioma

Astrocytoma

Neoplasms, Neuroepithelial

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms by Histologic Type

Neoplasms, Glandular and Epithelial

Neoplasms, Nerve Tissue

Neuroepithelioma

-15 Glioma Patients with progression will undergo DECT and MRS before Avastin (10 mg/kg iv q2 weeks until progression) and 3 months later

15 glioma patients not receiving Avastin for recurrence studied in the same manner as Arm 1

DECT at tumor progression and 3 months later

DECT

MR spectroscopy at tumor progression and 3 months later

MR spectroscopy

Barbara J Fisher, MD

This study aims to assess the effect of Avastin on brain vascularity and blood-brain permeability using dynamic contrast ct scans (DECT) and MRI imaging. Previous publications have documented the method by which DECT can determine alterations in vascular volume and tissue permeability within tumors and normal brain tissue. Functional maps of cerebral blood flow cerebral blood volume and permeability-surface area can be generated from the DECT studies to assess tumor perfusion. MRI spectroscopy analyzes brain chemistry to detect tumour versus edema versus normal brain. Thirty patients will receive MRI spectroscopy and DECT imaging at the time of presumed recurrence and 3 months later. 15 patients who do not receive Avastin and 15 patients who do receive Avastin as standard treatment for recurrence will be studied with DECT and MRI spectroscopy at baseline and then again in 3 months.

The clinical determination of the point of tumour progression or response is difficult to determine using standard diagnostic imaging ie CT/MRI especially following previous treatment with surgery, radiation and chemotherapy. Hemorrhage, edema, inflammation and vascular necrosis.

Both MR spectroscopy and DECT have been reported as being able to define areas of recurrent tumour as opposed to treatment-related effects. We wish to investigate the correlation between MR spectroscopy and DECT in assessing tumour progression or response to Avastin in comparison with patients not receiving Avastin.

Health Canada has approved Avastin for clinical use in patients with recurrent glioblastoma who have previously received temozolomide and radiotherapy. We propose to perform a DECT scan at baseline at presumed tumour progression and again 3 months to determine the effects of tumour progression/response on blood brain barrier permeability and vascular volume. The group of 15 patients will be compared to a group of 15 patients who do not receive Avastin at recurrence involving DECT scanning and MR spectroscopy at the time of the radiological progression and 3 months later.

Imaging Study of Glioblastomas Treated With Avastin

Feasibility Study of Magnetic Resonance Spectroscopy and Dynamic Enhanced Cat Scan Imaging in Glioblastomas Treated With and Without Avastin

participants who had reduction of tumor size from avastin at 3 months

University of Western Ontario, Canada

London Regional Cancer Program, Canada

London Health Sciences Centre

-15 Glioma Patients with progression will undergo DECT and MRS pre-Avastin and 3 months later

DECT: DECT at tumor progression and 3 months later

MR spectroscopy: MR spectroscopy at tumor progression and 3 months later

DECT/MRS in Patients Receiving Avastin

15 glioma patients not receiving Avastin for recurrence studied in the same manner as Arm 1

DECT: DECT at tumor progression and 3 months later

MR spectroscopy: MR spectroscopy at tumor progression and 3 months later

DECT/MRS in Glioma Patients Not Receiving Avastin

Total

Age, Continuous

<=18 years

Between 18 and 65 years

>=65 years

Age, Categorical

Female

Male

Gender

Canada

Region of Enrollment

Barbara Fisher

3 Month Response

3 Glioma Patients underwent DECT and MRS pre-Avastin and 3 months later after receiving avastin 10 mg/kg iv q2weeks

DECT: DECT at tumor progression and 3 months later

MR spectroscopy: MR spectroscopy at tumor progression and 3 months later Avastin 10 mg/kg iv q2weeks

0 glioma patients not receiving Avastin for recurrence studied in the same manner as Arm 1

DECT: DECT at tumor progression and 3 months later

MR spectroscopy: MR spectroscopy at tumor progression and 3 months later

Overall Study

Stefan Sunaert, MD, PhD

Uwe Himmelreich, PhD

In this study, we evaluate the role of diffusion kurtosis imaging (DKI) and MR spectroscopy (MRS), two advanced imaging techniques in magnetic resonance (MR) in grading and detection of microscopic infiltrating tumour in gliomas. These parameters are of utmost importance in optimal choice and planning of treatment.

Patients treated with gliomatous brain tumours are included voluntarily. They undergo one imaging session on a 3T MR scanner prior to treatment.

DKI data are quantitively analyzed in order to estimate specific parameters in normal appearing white matter, grey matter, tumor and peritumoral edema. MRS data are analyzed quantitatively and qualitatively with peak integration, ratio calculation and classification algorithms. Histological confirmation is obtained at subsequent surgery.

Information from this study can be of significant importance in avoiding brain biopsies. Furthermore, information on microscopic tumour spread can be used during neurosurgery or in radiotherapy planning. An important advantage of these advanced MR techniques is the non-invasivity and the lack of ionizing radiation, two important issues in this relatively young patient population.

standard neurosurgical procedure to obtain specimens; standard histopathological examination

Advanced MR Techniques in Detection of Tumor Infiltration and Grading in Gliomas

Diffusion Kurtosis Imaging en MR Spectroscopy in Grading and the Characterization of Tumour Infiltration in Gliomas

Universitaire Ziekenhuizen KU Leuven

Urinary Tract, Sexual Organs, and Pregnancy Conditions

Uterine Cervical Neoplasms

Body Weight

Uterine Neoplasms

Genital Neoplasms, Female

Urogenital Neoplasms

Uterine Cervical Diseases

Uterine Diseases

Genital Diseases, Female

Genital Diseases

Urogenital Diseases

Female Urogenital Diseases

Pregnancy Complications

Female Urogenital Diseases and Pregnancy Complications

* Clinical T1/T2-weighted MRI sequence per standard of care before treatment, during treatment per standard protocol, and at 3 months.
* Patients may have one or all of the following sequences in addition to the standard MRI imaging:

  * MR Spectroscopy
  * Fat-saturation and Diffusion-Weighted Imaging
  * Dynamic Contrast Enhancement MRI (MR-DCE)
  * Diffusion Tensor Imaging (DTI)

MR Spectroscopy

Fat-Saturation and Diffusion-Weighted Imaging

Dynamic Contrast Enhancement MRI (MR-DCE)

Diffusion Tensor Imaging (DTI)

Jacqueline Esthappan, Ph.D.

To detect differences in MR spectroscopy, diffusion weighted MR, diffusion tensor imaging (DTI) or dynamic contrast enhancement (DCE) MR imaging between primary cervical tumors and normal cervical tissue.

At our institution, all patients receiving external beam and/or brachytherapy as part of the treatment of primary cervical cancer receive CT, PET, and MRI simulation scans as standard of care. Brachytherapy patients also receive weekly T1/T2 weighted MR simulation scans as part of their treatment planning.

We propose the use of additional MR sequences to the standard T1/T2 weighted MR simulation scans. The data obtained from these additional sequences will be used for improving tumor delineation and obtaining prognostic information.

MRI (Including Spectroscopy and Fat-Saturations and Diffusion-Weighted Imaging) in Cervical Cancer

A Study of Novel Magnetic Resonance Imaging Sequences for Target Delineation and Prognostication in Cervical Cancer

Washington University School of Medicine

Heart and Blood Diseases

Mitral Valve Insufficiency

Marc Sanson, MD, PhD

Francesca Branzoli, PhD

In France, about 5000 new people with a primary malignant brain tumor are diagnosed each year. The most common primary tumors are gliomas, originating from glial cells (astrocytomas and oligodendrogliomas). Low-grade gliomas are mildly aggressive, but they often evolve into a more malignant form.

Mutations in the genes encoding isocitrate dehydrogenase (IDH) are found in about 80% of low-grade gliomas and are associated with a favorable prognosis. Remarkably, IDH-mutated gliomas are characterized by a specific cellular metabolism causing the accumulation of D-2-hydroxyglutarate (2HG) in tumor cells. 2HG can be detected in vivo using 1H magnetic resonance spectroscopy (MRS) and is recognized as a unique, noninvasive biomarker of IDH-mutated gliomas. Noninvasive detection of IDH mutations via 2HG MRS represents a crucial step for decision-making and patient care.

A subset of IDH-mutated tumors also presents a complete deletion of 1p and 19q chromosome arms (1p/19q codeletion). The 1p/19q codeletion is specifically linked to the oligodendroglial histologic subtype and it has been associated with a better patient outcome. However, the biological effects of this genetic alteration are still unclear and in vivo markers are lacking. Recently, we reported the first in vivo detection of the cystathionine molecule in human brain gliomas using MRS and explored the association between cystathionine accumulation and 1p/19q codeletion in gliomas.

In this project, the investigation team will combine cutting edge MRI and MRS techniques for metabolic and microstructural characterization of brain tumors with the aim of providing novel reliable noninvasive biomarkers of tumor genetic subtypes. These methods will enable noninvasive identification of IDH-mutated gliomas and, potentially, 1p/19q codeleted gliomas. In addition, the researchers will investigate the utility of 2HG, cystathionine and MRI microstructural markers to monitor tumor response to anti-cancer treatments and tumor progression.

The outputs of this project, altogether, may open new avenues to a better understanding of the pathophysiological mechanisms of oncogenesis and the design of new treatments for gliomas.

MRS of Glioma Genomics

Magnetic Resonance Spectroscopy Markers of Glioma Genomics

Concentrations of 2-hydroxyglutarate and cystahionine measured by MRS will be correlated with IDH mutational status and 1p19q codeletion derived from ex vivo analyses in tumor tissue samples

Diffusion MRI metrics will be correlated with the 1p19q codeletion status derived from ex vivo analyses in tumor tissue samples

The changes in concentration of 2-hydroxyglutarate, cystathionine and choline will be compared to the changes in tumor volumes and to the clinical response

Diffusion MRI and amide proton transfer signal changes will be compared to the changes in metabolism, tumor volumes and to the clinical response

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Imaging Study of Glioblastomas Treated With Avastin	NCT01549392	Malignant Gliom...	DECT MR spectroscopy	18 Years - 90 Years	London Health Sciences Centre
Advanced MR Techniques in Detection of Tumor Infiltration and Grading in Gliomas	NCT01225003	Gliomas		18 Years -	Universitaire Ziekenhuizen KU Leuven
Imaging Study of Glioblastomas Treated With Avastin	NCT01549392	Malignant Gliom...	DECT MR spectroscopy	18 Years - 90 Years	London Health Sciences Centre
MRI (Including Spectroscopy and Fat-Saturations and Diffusion-Weighted Imaging) in Cervical Cancer	NCT01060033	Uterine Cervica...	MR Spectroscopy Fat-Saturation ... Dynamic Contras... Diffusion Tenso...	18 Years -	Washington University School of Medicine
Advanced MR Techniques in Detection of Tumor Infiltration and Grading in Gliomas	NCT01225003	Gliomas		18 Years -	Universitaire Ziekenhuizen KU Leuven
MRS of Glioma Genomics	NCT05700071	Glioma	MRI	18 Years -	Institut National de la Santé Et de la Recherche Médicale, France

Spots Global Cancer Trial Database for mr spectroscopy