Predicting Sites of Tumour Progression in the Invasive Margin of Glioblastomas

Research summary

Brain tumours are the leading cause of cancer deaths in children, men under the age of 45 and women under the age of 25. Glioblastoma is the most common and most malignant primary tumour. The predominant treatment is surgical removal of the tumour followed by radiotherapy. Sadly the majority of patients given this treatment develop recurrent and progressive disease.

Better understanding of the invasive margin might improve outcomes by facilitating more complete surgical resection beyond the traditional contrast enhancing margins. Diffusion tensor MRI (DTI) is an imaging technique which may be able to predict the site of tumour recurrence. DTI has previously been shown to identify regions, which have been confirmed with biopsies, to be areas of invasive tumours and are present before progression is seen with an MRI.

The primary aim of this study is to qualify an imaging biomarker that can be applied at initial presentation, that can accurately predict the site of where glioblastomas will progress after treatment and allow personalisation of both radiotherapy and surgical targets.

Main inclusion criteria

  1. Have given written informed consent to participate

  2. Assessed by a neuroscience MDT to have a high grade glioma on imaging, OR if in the opinion of the CI, with guidance from the local PI that all relevant and appropriate members of a multidisciplinary team agree a high grade glioma diagnosis;

  3. Considered suitable for radical radiotherapy (60 Gy) with concomitant chemotherapy (Stupp Regime);

  4. WHO PS 0 or 1 (see Appendix 3);

  5. Age 16 - 75;

  6. Patient suitable for tumour resection where the treating neurosurgeon feels that >90% of the enhancing tumour will be resected

Main exclusion criteria

  • Patients who are participating in trials involving investigational treatments

  • Patients who are unsuitable for a contrast-enhanced MRI will be excluded. Such clinical problems include, but are not limited to:

  • MR unsafe metallic implants;

  • Claustrophobia;

  • Allergy to gadolinium contrast agent;

  • History of severe renal impairment.

  • Patients unable to provide written informed consent

  • PET sub-study only: Pregnant women

Chief investigator

Mr Stephen Price

Contact details

Cancer Theme Email: [email protected]