Project Details
Description
Aim of the project
The main clinical MRI merit of gadolinium-based contrast agents (GBCA) in glioma diagnostics is that they allow visually assessing tumor neovascularization and blood-brain barrier (BBB) leakage, two major indicators of tumor malignancy. However, American and European pharmacological safety agencies urge clinicians to reduce the use of contrast agents due to its possible side effects like dizziness, rare allergic reactions, and long-term accumulation and uncertainty about the consequences for patients and the environment. Moreover, GBCA increases the examination cost and adds patient discomfort and a logistic burden.
This proof-of-principle study investigates a new non-invasive, contrast-free MRI technique that simultaneously quantifies the BBB integrity, cerebral blood flow (CBF), and arterial transit time hemodynamics in glioma patients.
We will employ an extended arterial spin labeling (ASL) perfusion MRI technique that we refer to as BBB-ASL, which our collaborators and we have tested in healthy volunteers and dementia patients. We will add BBB-ASL to the MRI protocol of 50 pre-surgery patients with a suspected glioma (25 low-grade (LGG) and 25 high-grade (HGG)). We aim to:
1. investigate the within-subject within-session REPRODUCIBILITY of the non-invasive BBB-ASL sequence in glioma patients (ISMRM abstract);
2. assess the COMPARABILITY of BBB-ASL with established contrast-based MRI technique dynamic contrast enhanced (DCE) MRI (technical manuscript);
3. gain insight into the diagnostic APPLICABILITY of BBB-ASL in gliomas with respect to their tumor grade and mutation subtype (pilot results for KWF grant proposal). As the BBB-ASL effect size is currently unknown, the results from the abovementioned three aims will allow power calculations for further grant proposals.
The potential benefit of BBB-ASL is that it does not require GBCAs and is therefore 1) non-invasive and 2) cost-efficient. BBB-ASL acquires multiple tumor hemodynamics within a sequence, potentially shortening scanner time (3). Finally, 4) BBB-ASL might be an earlier and more sensitive biomarker as it relies on magnetically labeled blood water rather than the larger molecular-weight GBCA.
The main clinical MRI merit of gadolinium-based contrast agents (GBCA) in glioma diagnostics is that they allow visually assessing tumor neovascularization and blood-brain barrier (BBB) leakage, two major indicators of tumor malignancy. However, American and European pharmacological safety agencies urge clinicians to reduce the use of contrast agents due to its possible side effects like dizziness, rare allergic reactions, and long-term accumulation and uncertainty about the consequences for patients and the environment. Moreover, GBCA increases the examination cost and adds patient discomfort and a logistic burden.
This proof-of-principle study investigates a new non-invasive, contrast-free MRI technique that simultaneously quantifies the BBB integrity, cerebral blood flow (CBF), and arterial transit time hemodynamics in glioma patients.
We will employ an extended arterial spin labeling (ASL) perfusion MRI technique that we refer to as BBB-ASL, which our collaborators and we have tested in healthy volunteers and dementia patients. We will add BBB-ASL to the MRI protocol of 50 pre-surgery patients with a suspected glioma (25 low-grade (LGG) and 25 high-grade (HGG)). We aim to:
1. investigate the within-subject within-session REPRODUCIBILITY of the non-invasive BBB-ASL sequence in glioma patients (ISMRM abstract);
2. assess the COMPARABILITY of BBB-ASL with established contrast-based MRI technique dynamic contrast enhanced (DCE) MRI (technical manuscript);
3. gain insight into the diagnostic APPLICABILITY of BBB-ASL in gliomas with respect to their tumor grade and mutation subtype (pilot results for KWF grant proposal). As the BBB-ASL effect size is currently unknown, the results from the abovementioned three aims will allow power calculations for further grant proposals.
The potential benefit of BBB-ASL is that it does not require GBCAs and is therefore 1) non-invasive and 2) cost-efficient. BBB-ASL acquires multiple tumor hemodynamics within a sequence, potentially shortening scanner time (3). Finally, 4) BBB-ASL might be an earlier and more sensitive biomarker as it relies on magnetically labeled blood water rather than the larger molecular-weight GBCA.
| Acronym | BIG-BBB |
|---|---|
| Status | Not started |