Advanced MRI Measurements for Brain Tumor Treatment Management
Improving Diagnosis, Surgical Planning, and Treatment Response Evaluation
Welcome and Introduction
- Thank you to the Missile Foundation for the invitation
- Presenter: Kathleen Mind, Professor of Biophysics and Radiology
- Topic: Advanced MRI Measurements for Brain Tumor Treatment Management
- Objective: Improve diagnosis, surgical planning, and treatment response evaluation
Treatment Paradigm for Adult Brain Tumor
- Timeline of various treatments undergone by patients
- MRI used to establish initial diagnosis and evaluate tumor response
- Treatment options include surgery, chemotherapy, radiation therapy
- MRIs used to assess response and possible recurrence
Limitations of Standard MRI
- Standard MRI provides soft tissue contrast but lacks specific information about tumor growth patterns
- Advanced MRI metrics, such as perfusion and diffusion MRI, offer more detailed insights
- Perfusion MRI provides information about blood vessels throughout the brain
- Diffusion MRI gives information about tumor cells
Advanced MRI Metrics: Perfusion MRI
- Perfusion MRI maps blood vessels throughout the brain
- Can inform diagnosis, indicate tumor aggressiveness, and guide tissue sampling
- Helps delineate tumor extent and plan subsequent treatment
Advanced MRI Metrics: Diffusion MRI
- Diffusion MRI provides information about tumor cells and cell density
- Can help assess treatment response and distinguish tumor from treatment effects
- Used in combination with other metrics, such as perfusion and fractional tumor burden maps
Fractional Tumor Burden Maps
- Fractional tumor burden maps help differentiate tumor from treatment effects
- Provide clinically relevant information for treatment decisions
- Available through advanced MRI metrics
Clinical Application: Diagnosis and Surgical Planning
- Advanced MRI metrics assist in diagnosis and surgical planning
- Perfusion MRI correlates with tumor grade and helps locate aggressive areas
- Delta T1 map enhances tumor visualization and extent of resection
- Fractional tumor burden maps aid in surgical decision-making
Clinical Application: Treatment Response Evaluation
- Standard MRI encounters challenges in distinguishing tumor from treatment effects
- Pseudo progression complicates response evaluation
- Advanced MRI Metrics, such as Rc and Delta T1 maps, provide valuable information
- Fractional tumor burden maps offer insights into tumor response
Clinical Application: Treatment Selection at Recurrence
- Advanced MRI metrics aid in treatment selection at recurrence
- Rc can predict response to anti-VEGF therapy
- Delta T1 map enhances visualization of tumor and treatment effects
- Diffusion MRI offers insights into treatment response
Availability and Clinical Validation
- Advanced MRI metrics are commercially available
- Clinical trials and studies have demonstrated their accuracy and relevance
- National consensus protocols confirm their robustness
- Platform-agnostic and compatible with various MRI machines
Conclusion
- Advanced MRI metrics improve diagnosis, surgical planning, and treatment response evaluation
- Perfusion MRI and diffusion MRI offer valuable insights into tumor vascularity and cell density
- Fractional tumor burden maps aid in treatment decision-making
- Commercially available and nationally validated