Quantitative diffusion imaging for early treatment response & progression evaluation in adult high grade gliomas

Quantitative diffusion imaging for early treatment response and progression evaluation in adult high grade gliomas; a multi-centre study (NCRI Brain Clinical Studies Group, Imaging Subgroup)

3-year multi-centre project from October 2014-September 2017 (ongoing)

£37,485.00  co-funded with The Brain Tumour Charity

Investigators: Dr Adam Waldman (PI), Dr Alan Jackson, Dr Stephen Price, Dr Jeremy Rees, Prof Sebastian Brandner, Dr Dow Mu Koh, Dr Rolf Jager, Dr Naomi Fersht, Dr Sarah Jefferies, Mr David Peterson, Dr Frank Saran, Prof Jonathan Gillard

Lay summary: Glioblastomas are the most common and most aggressive adult brain cancers, and the commonest cause of cancer death in women under 35 and men under 45. With best current treatment, average survival is just over a year, so new treatments are urgently needed. A real problem is that standard MRI scanning is not good at detecting how well the tumour responds to treatment early, and can sometimes be misleading; tumours may appear to grow when they are actually responding to treatment, and conversely appear to shrink when they are progressing. We therefore require better scanning methods to assess whether a particular treatment is working for an individual patient and for testing new anti-cancer drugs in trials are required. A specialised type of MRI scan called diffusion weighted imaging (DWI) allows the properties of water in the tumour and surrounding brain to be measured. DWI has been shown to detect a tumour responding to treatment much earlier than standard MRI, but has only been tested in single centres. The best way of acquiring and analysing DWI and comparing results from different MRI scanners for clinical use has not been established. This project aims to develop, test and refine DWI as a method that can be used across multiple centres to measure tumour treatment response and growth into surrounding normal brain in patients with glioblastoma. 120 patients with newly diagnosed glioblastoma having standard treatment with surgery, radiotherapy and chemotherapy at five specialist brain tumour centres will have MRI and DWI scans before and after treatment. Patients DWI data will be compared with their subsequent progress and survival, and the best DWI indicators selected.

The intended impact is:

  • Improved personalised treatment decision making for individual patients.
  • More reliable early assessment of the effectiveness of new drugs and drug combinations in multi-centre trials, for improved future patient care.