Primary brain tumors are the leading cause of cancer-related deaths in children and the fourth leading cause of cancer-related deaths in people under the age of 54. Recently, a significant increase in the incidence of brain tumors has been observed in people over the age of 60. Survival for adult primary brain tumors ranges from 8-9 months to 2-3 years despite standard therapies such as surgery, radiation therapy and chemotherapy. The most aggressive brain tumors are those characterized by the formation of new blood vessels a process called angiogenesis. Consequently, new drugs that inhibit angiogenesis (i.e. antiangiogenic drugs), are a particularly promising alternative for this patient population. To capitalize on this promise a reliable and reproducible, non-invasive method is needed to efficiently optimize and evaluate new therapeutic approaches to brain tumors. ? ? Dynamic susceptibility contrast (DSC) MRI methods, which allow the creation of relative cerebral blood volume (rCBV), cerebral blood flow (CBF) and mean transit time (MTT) maps, have the potential to fulfill this promise. However, despite the widespread and well-published potential, the clinical adoption rate of DSC studies in brain tumors has been impeded. This has been attributed to the lack of one or two generally accepted methods for use in brain tumors. To address this issue a DSC comparison study was performed in the laboratory of Dr. Schmainda (co-investigator on this grant). This study was designed to directly compare, in brain tumor patients, the most commonly used and published DSC acquisition and analysis methods. The results of this study demonstrate that there are two (of 26 tested) approaches that appear to be the most accurate and reliable. The first approach uses currently available MR imaging sequences and a post- processing correction algorithm. The 2nd approach is a new approach, which was developed as a result of the understanding derived from the comparison study. This approach, for which Imaging Biometrics has a patent pending, entails using a dual-echo SPIRAL imaging sequence in combination with a post-processing correction algorithm. These two approaches form the core of the perfusion technology that Imaging Biometrics LLC proposes to develop. ? ? The overall goal is to make this software user-friendly and widely available to both the research and clinical community. To accomplish this goal the following two specific aims will be addressed:
Aim 1 : To convert the research laboratory code into code that is compliant with industry and FDA standards. The approach will be to rewrite the currently available post-processing software, developed for research purposes, into a base library using platform-independent C/C++.
Aim 2 : To adapt the software to plug into an existing vendor s viewing and display workstation. The approach will be to implement the appropriate software interfaces to allow the post- processing software in the base library of Aim 1 to be integrated as a feature into open-source and commercial image viewing software. Addressing these aims will enable the translation of robust perfusion technologies from the laboratory into the clinic. Ultimately, this should aid in the discovery of new drugs and therapeutic strategies that can be adapted on a per-patient basis. ? ? ?
