Quantitative MRI of Glioblastoma Response
Bruce Rosen M.D., Ph.D.
Massachusetts General Hospital
Grant Number: U01 CA154601
Assessment of anti-angiogenic therapies for the most severe form of brain cancer, glioblastoma, is extremely timely given the recent approval of bevacizumab, yet the moderate response rate and the challenging side effects of these therapies means there is a need for imaging biomarkers to assess therapeutic results. Clinical decision-making tools are needed, and recently published data from this QIN team suggest that measurement of microvascular properties of the tumor using MRI and gadolinium-based approaches could be very useful. With proper quantitative measures, these methods appear to be capable of serving as an effective prognostic imaging biomarker, and may be beneficially combined with blood biomarkers. The QIN investigators at MGH will develop improved analysis methods for dynamic contrast enhanced MRI and dynamic susceptibility MRI that will improve quantification and decrease variability. The investigators will develop techniques that will be applicable in the multicenter setting through a bottom-up approach of simulations, phantom studies, retrospective analysis, and prospective analysis in patients undergoing treatment with anti-angiogenic therapies. They project that this approach will improve the reliability of advanced microvascular MRI methods as potential imaging biomarkers, and pave the way for a clinically useful decision-making tool.
Advanced MRI methods may improve the ability to provide an accurate prognosis and potentially guide treatment choices for glioblastoma patients. The proposed research will help establish a common, standardized approach to acquisition and analysis of two forms of vascular MRI that have shown excellent promise. The investigators will do this by careful reduction of variability. These efforts will enable these advanced techniques to become more widely available and more appropriately establish their benefit to patients.
The Specific Aims of the program will include:
Aim 1: Improve the performance of Ktrans as an imaging biomarker in anti-VEGF treatment of GBM,
Aim 2: Improve the performance of DSC as an imaging biomarker in anti-VEGF treatment of GBM, and
Aim 3: Conduct additional biomarkers explorations and optimizations in harmony with the QIN.