Grant: Project Grant

Glioma is the most common and aggressive form of brain cancer. The current standard of care is surgery followed by radiation treatment (XRT) and chemotherapy. A major challenge with XRT is determining tumour response, which is currently done by assessing changes in tumour size. It may take weeks before significant changes in tumour size occur, by which time the therapeutic window is often lost. Clinically, early identification of non-responders may significantly improve outcomes by allowing the oncologist to change the treatment. We developed new MRI techniques to characterize tumour environment which have the potential of predicting tumour response to XRT. This study has two major goals: 1.To assess tumour response to XRT with novel MRI sequences and to identify the optimal MRI protocol to distinguish between responders and non-responders. 2.To differentiate radiation necrosis or pseudo-progression from tumour progression with MRI. Our preliminary data has shown that: 1.MRI can predict tumour response as early as two weeks after the start of the XRT. 2.MRI characteristics of brain tissue are significantly different than in normal controls. 3.MRI features of white matter have the potential to predict tumour response before the treatment. We aim to find the earliest time-point and the optimal MRI protocol that allow for robust tumour response monitoring. 110 patients will be recruited for this study. These patients will be MRI scanned immediately before treatment and then will be monitored by MRI during the course of XRT. We are proposing novel MRI approaches for non-invasive characterization of cancer therapy. It will also offer the means to evaluate treatment effects relatively early so appropriate changes in patient management can be made. Our proposed methods are not limited to glioma. They can be used for many cancers and treatment regimens.