An Investigational Scan (7T MRI) for the Imaging of Central Nervous System Tumors

PRIMARY OBJECTIVE:

I. To estimate the contrast-to-noise ratio (CNR) for several imaging modalities in brain malignancy as compared with normal brain parenchyma separately by type of malignancy and treatment status.

SECONDARY OBJECTIVE:

I. To assess the conspicuity of each imaging modality to differentiate radiation necrosis from progressive disease.

EXPLORATORY OBJECTIVES:

I. To assess patient experience in the 7 Tesla (7T) magnetic resonance imaging (MRI) system compared to their most recent MRI examination.

II. To assess the typical significance values seen for areas of maximal brain activity associated with each functional MRI (fMRI) test.

III. To assess the geometric distortion of a radiation planning sequence on a ultra-high field (UHF) system.

OUTLINE:

Patients undergo 7T MRI over 60 minutes.

• 7 Tesla Magnetic Resonance Imaging (Procedure), also known as 7 Tesla MRI, 7T MRI: Undergo 7T MRI
• Questionnaire Administration (Other): Ancillary studies

Primary outcomes

• Contrast-to-noise Ratio (CNR) [1 year]: Contrast-to-noise ratio (CNR) refers to the difference in signal intensity between the tumor and surrounding tissue. Higher CNR values indicate better image quality.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Adult patients must meet one set of inclusion criteria:

  * Newly identified and untreated central nervous system glioma or metastasis of at least 5 mm or greater in size

    * Suspected central nervous system neoplasms will require agreement from a study neuroradiologist and a study neurosurgeon or a radiation oncology that a lesion exists that is most likely either a glioma or a metastasis
    * Patients with suspected brain metastasis must also have a history of solid organ malignancy
  * History of central nervous system glioma or metastasis treated with surgery, radiation, chemotherapy, or immunotherapy with new or increasing signal on MR imaging that is suspicious for progressive disease (treatment failure)

    * Suspected recurrent neoplasms will require agreement from a study neuroradiologist and a study neurosurgeon, radiation oncologist, or neuro-oncologist that lesion behavior is suspicious for recurrent disease

Exclusion Criteria:

* Contraindication to MR imaging
* Absolute or relative contra-indication to 3T MRI due to metallic foreign bodies and devices and/or other conditions that are not MR safe, which include implants with unknown behavior in 3T MRI as well as:

  * Electronically, magnetically, and mechanically activated implants
  * Ferromagnetic or electronically operated active devices like automatic cardioverter defibrillators and cardiac pacemakers
  * Metallic splinters in the eye
  * Ferromagnetic hemostatic clips in the central nervous system (CNS) or body
  * Cochlear implants
  * Other pacemakers, e.g., for the carotid sinus
  * Insulin pumps and nerve stimulators
  * Non-MR safe lead wires
  * Prosthetic heart valves (if dehiscence is suspected)
  * Non-ferromagnetic stapedial implants
* Pregnancy
* Claustrophobia that does not readily respond to oral medication
* Known allergy to gadolinium-based contrast agents
* Renal failure as defined by a glomerular filtration rate (GFR) less than 30 or the use of hemodialysis
* Pregnant
* Interval treatment with radiation or surgery between the diagnostic MRI lesion identification and planned study MRI

Participant flow

Outcome results

• Contrast-to-noise Ratio (CNR) (Primary), Mean, contrast-to-noise ratio: Group 1 60.6 +/- 26.6; Group 2 58.4 +/- 28.0

Adverse events

Time frame: 6 months

• Study Protocol and Statistical Analysis Plan (PDF, 2023-08-25)
• Informed Consent Form (PDF, 2023-08-07)

• Max Wintermark, Principal investigator, M.D. Anderson Cancer Center