Feasibility Study of Magnetic Resonance Spectroscopy and Dynamic Enhanced Cat Scan Imaging in Glioblastomas Treated With and Without Avastin
The clinical determination of the point of tumour progression or response is difficult to
determine using standard diagnostic imaging ie CT/MRI especially following previous
treatment with surgery, radiation and chemotherapy. Hemorrhage, edema, inflammation and
Both MR spectroscopy and DECT have been reported as being able to define areas of recurrent
tumour as opposed to treatment-related effects. We wish to investigate the correlation
between MR spectroscopy and DECT in assessing tumour progression or response to Avastin in
comparison with patients not receiving Avastin.
Health Canada has approved Avastin for clinical use in patients with recurrent glioblastoma
who have previously received temozolomide and radiotherapy. We propose to perform a DECT
scan at baseline at presumed tumour progression and again 3 months to determine the effects
of tumour progression/response on blood brain barrier permeability and vascular volume. The
group of 15 patients will be compared to a group of 15 patients who do not receive Avastin
at recurrence involving DECT scanning and MR spectroscopy at the time of the radiological
progression and 3 months later.
Allocation: Non-Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Diagnostic
Determination of Tumor Progression using DECT and MR spectroscopy scans
Dynamic Enhanced Ct imaging (DECT) is a method developed for measurement of blood-brain barrier permeability and vascular volume which can then be graphically represented by functional images. MR spectroscopy is a technique that is able to characterize biochemical, metabolic and pathologic changes of brain tissue to provide information concerning the spatial extent of cellular metabolites in the brain.
after second set of DECT and MRI spectroscopy scans (average of 3 months)
Barbara J Fisher, MD
London Regional Cancer Program
Canada: Ethics Review Committee