Quantitative Sodium Magnetic Resonance Imaging and Chemical Exchange Saturation Transfer (CEST) of Low-Grade Gliomas in Children with Neurofibromatosis Type 1
Abstract
Currently, the standard approach of monitoring brain tumors includes radiology imaging, such as MRI. These MRIs provide important information for the clinical doctors but have many limitations in knowing whether there is a brain tumor and whether a cancer treatment is working. Children with neurofibromatosis type 1(NF1) have an increased risk over their lifetime of developing brain tumors; however, they also develop benign lesions in the brain that we cannot distinguish from tumors on MRI, due to their similar imaging appearance on MRI. We are researching an MRI approach to looking at more advanced imaging techniques, such as sodium levels in the brain and brain tumors, since we know brain tumors have increased sodium and protein levels based on our preliminary data and literature. However, much more data are needed, and there are no research studies in children. Low-grade gliomas are common brain tumors in children with NF1 that can be treated with chemotherapy. After treatment, the goal is for the tumor to shrink in size or stop growing, but treatment changes can make the tumor look as it is still progressing with more enhancement on MRI, and we currently do not have an easy way to determine this with clinical MRIs. Biopsy cannot be performed at multiple timepoints during treatment due to the risk of complications. Biopsy is not a simple procedure for patients; there is sedation, time needed in the hospital, and risk of bleeding and infections. We believe measuring the sodium values and protein levels in tumors with these advanced imaging techniques (sodium MRI and chemical exchange saturation transfer) proposed in this grant will help know earlier than current imaging being performed in hospitals on when children with NF1 develop brain tumors. This research study will also help radiologists, such as myself, know whether the signal abnormality in the brain is a tumor or rather a benign abnormality in the brain that looks like tumor commonly seen in NF1 patients. These advanced imaging techniques have the potential to help understand whether a child needs chemotherapy and if cancer treatment is working. This study overall will help us understand the behavior in brain tumors that cannot be obtained with the current clinical MRIs. We will use this data from this study to help support funding for larger studies in NF1 patients, including adults through the collaboration at the University of Penn/Penn Hospital. These advanced MRI techniques will make an accurate diagnosis of tumors, and determine whether they are responding or not responding to treatments, allowing doctors to make treatment decisions quickly to improve outcomes of children with NF1 and brain tumors.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 04, 2024
- Source ID
- HT94252310345
Entities
People
- Aashim Bhatia
Organizations
- United States Army