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

Nervous System Diseases

Brain Neoplasms

Central Nervous System Neoplasms

Nervous System Neoplasms

Brain Diseases

Central Nervous System Diseases

Patient with brain SOL underwent MRI Spectroscopy to be compared with later pathology

MRI Spectroscopy

Mohamed AbdelWahab, Msc

In order to come as close as possible to the correct diagnosis of CNS tumors, MRI is the long-standing accepted method of choice that can in some cases be supported by the use of CT to demonstrate calcification or bone destruction. In individual cases MRI spectroscopy can be helpful for the differentiation between neoplasms and inflammatory lesions or surveillance of tumor therapy, just as perfusion

Proton magnetic resonance spectroscopy (H-MRS) may be helpful in suggesting tumor histology and tumor grade and may better define tumor extension and the ideal site for biopsy compared with conventional magnetic resonance (MR) imaging. A multifunctional approach with diffusion-weighted imaging, perfusion-weighted imaging, and permeability maps, along with H-MRS, may enhance the accuracy of the diagnosis and characterization of brain tumors and estimation of therapeutic response. Integration of advanced imaging techniques with conventional MR imaging and the clinical history help to improve the accuracy, sensitivity, and specificity in differentiating tumors and nonneoplastic lesions.

Role of MR Spectroscopy in Brain Tumors

Role of Magnetic Resonance Spectroscopy in Differentiating Brain Tumors

Analysis of the MRS metabolites peaks and integral and test if they can differentiate the grades of brain tumors

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
Role of MR Spectroscopy in Brain Tumors	NCT03619694	Brain Neoplasms	MRI Spectroscop...	18 Years - 75 Years	Assiut University
Imaging Study of Glioblastomas Treated With Avastin	NCT01549392	Malignant Gliom...	DECT MR spectroscopy	18 Years - 90 Years	London Health Sciences Centre

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