MRI for Brain Tumor Detection After Radiation
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Dana-Farber Cancer Institute
Disqualifiers: Chronic kidney disease, Pregnancy, others
No Placebo Group
Approved in 1 Jurisdiction
Trial Summary
What is the purpose of this trial?This research study is investigating the value of an imaging study of the brain called an MRI (which stands for magnetic resonance imaging), utilized in unique way, to delineate whether the tumor has recurred or whether radiation changes have occurred after a brain metastasis treated with focused radiation has enlarged.
Do I have to stop taking my current medications for the trial?
The trial protocol does not specify whether you need to stop taking your current medications. Please consult with the study team for guidance.
What data supports the idea that MRI for Brain Tumor Detection After Radiation is an effective treatment?
The available research shows that MRI is more effective than CT scans for detecting changes in brain tumors after radiation. MRI can reveal details that CT scans might miss, such as distinguishing between tumor recurrence and radiation damage. In one-third of cases studied, MRI detected issues that were not visible on CT scans, allowing for better treatment adjustments and more accurate diagnoses. This makes MRI a valuable tool for monitoring brain tumors after radiation therapy.
12345What safety data exists for MRI in brain tumor detection after radiation?
The studies provided do not directly address safety data for MRI in brain tumor detection after radiation. However, they highlight the use of MRI in radiation therapy planning and monitoring for glioblastoma and other brain tumors. MRI is used to adapt treatment to tumor changes, assist in differentiating necrosis from recurrence, and improve target volume delineation. These applications suggest MRI's role in enhancing treatment precision and potentially reducing radiation-induced toxicity, but specific safety data is not detailed in these abstracts.
678910Is MRI a promising treatment for detecting brain tumors after radiation?
Yes, MRI is a promising treatment for detecting brain tumors after radiation. It is more sensitive than older methods like CT scans, helping doctors see changes in the brain more clearly. This allows for better diagnosis and treatment planning, making it easier to tell if a tumor is coming back or if there is damage from radiation.
1351112Eligibility Criteria
This trial is for adults with confirmed extracranial solid malignancies and brain metastases previously treated with focused radiation. They must be planning neurosurgical resection as standard care, agree to use contraception, and be able to consent. Excluded are those with severe kidney disease, gadolinium allergy, pregnancy, breastfeeding or MRI contraindications.Inclusion Criteria
I am 18 years old or older.
I have cancer that started outside the brain but now has spread to the brain, and I've had radiation for it.
I have a growing brain lesion after radiation, needing surgery.
+4 more
Exclusion Criteria
Pregnant women
I have advanced chronic kidney disease or am in end stage renal failure.
You have had a severe allergic reaction to gadolinium in the past.
+2 more
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Preoperative Assessment
Participants undergo preoperative MRIs with Treatment Response Assessment Maps (TRAMs) to delineate tumor recurrence from radiation changes
Within 3 months of study enrollment
Follow-up
Participants are monitored for safety and effectiveness after the preoperative assessment
4 weeks
Participant Groups
The study tests a specialized MRI technique to distinguish between tumor recurrence and radiation changes in the brain after stereotactic radiation therapy for brain metastases. Participants will undergo this imaging method before planned surgical removal of the lesion.
1Treatment groups
Experimental Treatment
Group I: TRAMs IExperimental Treatment1 Intervention
* Magnetic resonance imaging (MRI)-based treatment response assessment maps (TRAMs)
* Patients with an enlarging lesion in the site of a brain metastasis treated with stereotactic radiation for which neurosurgical resection is planned will undergo preoperative TRAMs
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Dana Farber Cancer InstituteBoston, MA
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Who Is Running the Clinical Trial?
Dana-Farber Cancer InstituteLead Sponsor
References
Characterisation of Lesions after Stereotactic Radiosurgery for Brain Metastases: Impact of Delayed Contrast Magnetic Resonance Imaging. [2018]To investigate if brain metastases and radiation injuries after stereotactic radiosurgery (SRS) have different signal intensity (SI) time courses up to 55 min after contrast agent application and if delayed contrast magnetic resonance imaging (MRI) contributes to improve diagnostic accuracy.
Irradiation of the cervix uteri: value of unenhanced and contrast-enhanced MR imaging. [2022]To analyze the value of magnetic resonance (MR) imaging after radiation therapy for cancer of the cervix.
Diffusion weighted imaging in radiation necrosis. [2019]This case report suggests that magnetic resonance imaging with diffusion weighted imaging may help distinguish between tumour recurrence and radiation induced necrosis in patients previously treated for a brain tumour.
[Multimodal magnetic resonance imaging of brain tumors]. [2011]Magnetic resonance imaging arose as a reference for diagnosis, pre-therapeutic and follow-up of brain tumors. Among parameters obtained from standard MRI (of low specificity), only volumetric growth allows prognostic information. The multiple "advanced" sequences have leaded to increase both sensitivity and specificity of brain MRI. Yet, perfusion-weighted imaging and spectroscopy provide metabolic information, and diffusion tensor imaging and cortical activation provide functional information. Characterization, grading, therapeutic management and follow-up have improved, with prognostic information.
Imaging of irradiated brain tumours. Value of magnetic resonance imaging. [2019]Until recently, computerized tomography (CT) was the most sensitive and reliable imaging method to follow up patients with an irradiated brain tumour, but it is difficult or impossible with CT to differentiate between radionecrosis, residual tumour or recurrent tumour. Magnetic resonance imaging (MRI) has become the most sensitive examination. It ensures optimal focusing of radiography, thereby increasing its effectiveness and reducing its complications. In one-third of the cases studied, MRI has shown pathological signals that were invisible at CT, making for a better adjustment of treatment and a more accurate diagnosis. As regards specificity, MRI does not seem to provide criteria that would enable a radiation lesion to be distinguished from a tumoral recurrence. However, we found that certain signs may contribute to the aetiological diagnosis: a perilesional high-intensity signal extending to the grey matter and/or the corpus callosum is in favour of a recurrent tumour; a high-intensity signal on T1- and T2-weighted sequences and a disproportionally moderate mass syndrome are in favour of a radionecrosis; a post-irradiation leucoencephalopathy sparing the grey matter and the corpus callosum is in favour of a remission. Injecting a gadolinium complex always gives a better distinction between oedema, tumour and necrosis, it may also improve MRI sensitivity and sensitivity in some cases, and it reduces the time taken by the examination. MRI is now the reference morphological examination; its specificity can be further increased by positron emission tomography and assays of polyamines in red blood cells.
Quantitating Interfraction Target Dynamics During Concurrent Chemoradiation for Glioblastoma: A Prospective Serial Imaging Study. [2021]Magnetic resonance image (MRI) guided radiation therapy has the potential to improve outcomes for glioblastoma by adapting to tumor changes during radiation therapy. This study quantifies interfraction dynamics (tumor size, position, and geometry) based on sequential magnetic resonance imaging scans obtained during standard 6-week chemoradiation.
Impact of Postoperative Changes in Brain Anatomy on Target Volume Delineation for High-Grade Glioma. [2023]High-grade glioma has a poor prognosis, and radiation therapy plays a crucial role in its management. Every step of treatment planning should thus be optimised to maximise survival chances and minimise radiation-induced toxicity. Here, we compare structures needed for target volume delineation between an immediate postoperative magnetic resonance imaging (MRI) and a radiation treatment planning MRI to establish the need for the latter. Twenty-eight patients were included, with a median interval between MRIs (range) of 19.5 (8-50) days. There was a mean change in resection cavity position (range) of 3.04 ± 3.90 (0-22.1) mm, with greater positional changes in skull-distant (>25 mm) resection cavity borders when compared to skull-near (≤25 mm) counterparts (p < 0.001). The mean differences in resection cavity and surrounding oedema and FLAIR hyperintensity volumes were -32.0 ± 29.6% and -38.0 ± 25.0%, respectively, whereas the mean difference in midline shift (range) was -2.64 ± 2.73 (0-11) mm. These data indicate marked short-term volumetric changes and support the role of an MRI to aid in target volume delineation as close to radiation treatment start as possible. Planning adapted to the actual anatomy at the time of radiation limits the risk of geographic miss and might thus improve outcomes in patients undergoing adjuvant radiation for high-grade glioma.
Technical feasibility of integrating 7 T anatomical MRI in image-guided radiotherapy of glioblastoma: a preparatory study. [2018]The use of 7 Tesla (T) magnetic resonance imaging (MRI) has recently shown great potential for high-resolution soft-tissue neuroimaging and visualization of microvascularization in glioblastoma (GBM). We have designed a clinical trial to explore the value of 7 T MRI in radiation treatment of GBM. For this aim we performed a preparatory study to investigate the technical feasibility of incorporating 7 T MR images into the neurosurgical navigation and radiotherapy treatment planning (RTP) systems via qualitative and quantitative assessment of the image quality.
Although Non-diagnostic Between Necrosis and Recurrence, FDG PET/CT Assists Management of Brain Tumours After Radiosurgery. [2017]To re-evaluate the role of (18)F-fluoro-deoxy-D-glucose (FDG) positron emission tomography/ computer assisted tomography (PET/CT) co-registered with magnetic resonance imaging (MRI) in differentiating adverse radiation effect (ARE) from tumour recurrence after Gamma Knife radiosurgery of brain tumours.
MRI-guided radiotherapy for head and neck cancer: initial clinical experience. [2022]To report a single-institutional experience with the use of magnetic resonance imaging (MRI)-guided radiotherapy for cancers of the head and neck.
Magnetic resonance imaging evaluation of brain glioma before postoperative radiotherapy. [2021]To investigate the magnetic resonance imaging (MRI) images of brain glioma before postoperative radiotherapy, and to provide reference for the delineation of postoperative radiotherapy target area.
Pediatric brainstem glioma. Post-radiation clinical and MR follow-up. [2019]Thirty-four pediatric patients, twenty with presumed and fourteen with biopsy or autopsy proven brainstem gliomas were imaged by CT and MR before radiation therapy. Twenty-eight patients received radiotherapy. Of these, eighteen fit the protocol for combined clinical and MR post-treatment evaluation. No cases of radionecrosis were seen at autopsy. This study shows that MR can demonstrate tumor response to radiation therapy, tumor progression prior to clinical deterioration, post-treatment cyst formation and hemorrhage. Although MR clinical correlation was not optimal on six week post-treatment evaluation, 4-10 month post-treatment MR scanning correlated well with clinical evaluation. MR appears useful in post-therapeutic monitoring of tumor response.