A Dual-Modality Molecular Imaging Strategy for Combined Pre- and Intraoperative Imaging of Gliomas
Moritz Kircher, M.D.,Ph.D.
Memorial Sloan-Kettering Cancer Center
David Mahoney Neuroimaging Program
September 2011, for 3 years
New imaging technique may facilitate surgical precision in removing entire brain tumor
This study will validate a new MRI imaging technique in an animal model of brain tumor that could enable surgeons to precisely remove all tumor cells to extend survival and possibly save lives.
Patients with deadly brain tumors (glioma) rarely live more than two years after the tumor is surgically removed. Current MRI techniques do not enable neurosurgeons to detect residual microscopic cancer cells that have migrated beyond the edges (“margins’) of the tumor mass and infiltrated many other brain areas. Consequently, tumor recurs, and the patient dies. Current MRI techniques simply lack spatial resolution and the ability to detect all cancer cells (sensitivity) and only cancer cells (specificity).
The Sloan-Kettering investigators have developed a new approach to MRI imaging of brain gliomas that they hypothesize will have adequate sensitivity, specificity and spatial resolution to prevent tumor recurrence. They will undertake studies in animals with transplanted human glioma to validate the technique’s effectiveness. The technique involves a single intravenous injection into the patient of a nanoparticle, a tiny molecular probe that attaches solely to glioma cells. The nanoparticle is highly permeable, so it can get into the brain and into any brain cell that has been infiltrated by tumor. Moreover, it lasts for a week. So, after using this MRI imaging technique preoperatively to map the surgical plan, the surgical team will use a hand-held “Ramon” imaging device during surgery to pick up the nanoparticle’s signal. This will enable the neurosurgeon to identify any and all tumor cells and remove them, while sparing healthy brain tissue. Then the investigators will examine the surgically removed tissue to verify that it contains tumor cells and will examine the remaining autopsied brain tissue to verify that it contains no tumor cells.
Significance: If successful in the animal model, this imaging technique will be rapidly translated into clinical trials in patients with deadly brain tumors and may ultimately improve outcomes.