Article
Methods
Research
Question
Results
GBM
Parametric
Response
Map/Quantitative
MRI
1 - Prospective
Analysis of
Parametric
Response Map–
Derived MRI
Biomarkers:
Identification of
Early and Distinct
Glioma Response
Patterns Not
Predicted by
Standard
Radiographic
Assessment
2Updated
Response
Assessment
Criteria for HighGrade
Gliomas: Response
Assessment in
Neuro-Oncology
Working Group
45 patients with
grade 3 or 4 gliomas
were taken for
experimental
parametric response
mapping through
quantitative ADC
and rCBV MRI’s.
Patients were
evaluated
pretreatment, 3 and
ten weeks into
therapy.
Can parametric
response mapping
using perfusion and
diffusion- weighted
MRI brain tumor
maps combined with
multiple imaging
treatments be used
to increase clinical
application
Quantitative MRI’s were indeed quite
useful/accurate in predicting accurate life
longevity measurements. T1-weighted images
that were contralateral to the affected area
were used to create a PMR and relative
cerebral blood volume and flow were both
calculated by normalizing the RCB/RCF map
values. These ultimately created a real time
image that more closely monitored progression
and efficacy of treatment
X
X
By taking several
radioneurologists
and oncologists, the
McDonald criteria
have been
recognized as
outdated. Through
the use of CT/MRI
scanning, new
criteria are being
created.
Can new criteria for
high grade glioma
patients be created
as to fully cover all
grounds of radiology
imaging sequencing
mechanisms to
measure therapy
productivity
The Macdonald criteria were critically
evaluated and assessed from multiple angles
from multiple professions. The addition of
definition of cross sectional diameter and the
inclusion of the non-enhancing section on a T2
weighted dynamic susceptibility contrast MR
image improved prognosis calculations by a
margin of 15-20 percent
X
X
Enhanced Cell
Detection
Treatment
Efficacy
X
3
Because both EphA2
and EphrinA1
display specific
patterns of
expression, it is
necessary to
measure them at
critical points of
peak expression,
and monitor the
relationship
between
protein/binding
expression through
the use of miniature
nuclear magnetic
resonance imaging
with the progression
of the GBM cells
Can the protein
EphA2 and its
binding ligand
EphrinA1 be used as
potential biomarkers
by the use of
expression
monitoring to better
understand GBM
cells. If so, can it be
used to explain GBM
pathogenesis or for
molecular
therapeutics against
GBM
EphA2 was found to be significantly overexpressed in GBM patients, which is consistent
with other findings in lung, ovarian, colon, and
liver cancers. It was found that when EphA2
was unable to bind to the extremely underexpressed complementary ligand, that the
tumor cells became far more aggressive. This is
thought to be due to the unstable cell-cell
contacts within cancer tissue, which would in
turn limit the ability of the EphA2 to come in
contact with the already thinly spread ligand.
X
X
4
Using a scaled NMR
imaging system in
combination with a
newly engineered
micro-fluidic chip,
blood can be taken
from a high grade
glioma patient that
has been injected
with GBM targeting
nano-particles that
can then be studied
by researchers
Are these
membrane-bound
microvesicles shed
by tumors in GBM
patients a key to
creating a real-time
monitoring strategy
for both the
progression of the
tumor, as well as
treatment? If so,
what is the next step
necessary to making
this happen.
Researchers found that GBM patients had highdensity quantities of these microvesicles and
were able to gain rudimentary results. Nanoparticles have not been developed to the point
where we can study the movement and
development of tumor cells and microvesicle
interaction, however it was able to be
determined that they can help us predict
primary tumor mutations as well as treatment
induced changes. In combination with MRI
imaging, it is a big step towards monitoring
pseudoprogression
X
X
EphA2 as a novel
molecular marker
and target in
Glioblastoma
Multiforme
Protein typing of
circulating
microvesicles
allows real-time
monitoring of
glioblastoma
therapy
X
5
T2 weighted
dynamic
susceptibility
contrast magnetic
resonance imaging
in combination with
normalized
apparent diffusion
coefficient and
relative cerebral
blood flow/volume
levels to create a
parametric response
mapping of tumor
progression
Since 20-30 percent
of high grade glioma
patients are
diagnosed falsely
under
pseudoprogression,
researchers wonder
if PMR can help to
clarify MRI results
Using the normalized values of the rCBV/rCBF
mapping sequences, the detection of
pseudoprogression was increased, and 6-8
percent of patients were correctly diagnosed
out of the 20-30 originally put in the pseudo
pile.
X
6
Injection of
targeting
nanoparticles into a
patient’s
bloodstream in
order to measure
platelet interactions
with the blood-brain
barrier.
Can nanoparticles be
used to increase
sensitivity of cell
detection, specifically
antibodies crossing
the blood-brain
barrier? If so, can it
be used to fight
tumor cells in
Glioblastoma
Multiforme patients
The results of these tests were largely
inconclusive, although there is a good lead in
advancement in a micro-fluidic chip (see article
4). The application is promising for biomedical
research
X
Parametric
response map as
an imaging
biomarker to
distinguish
progression from
pseudoprogression
in high grade
glioma patients
Bioorthogonal
chemistry
amplifies
nanoparticle
binding and
enhances the
sensitivity of cell
detection
X
X
X