Diagnostic Imaging Brain
James Talbot
Under the joint leadership of nuclear physician Nathalie Albert from LMU and oncologist Professor Matthias Preusser from the Medical University of Vienna, the RANO group has developed new criteria for assessing the success of therapies for diffuse gliomas. These malignant brain tumors develop out of glial cells in the brain. Tumors of this kind are generally aggressive and difficult to treat. The RANO group has developed criteria that permit evaluation of the success of treatment using positron emission tomography (PET). Called PET RANO 1.0, these PET-based criteria open up new possibilities for the standardized assessment of diffuse gliomas.
PET is an imaging technique that uses a radioactive tracer to measure metabolic processes in the body. Amino acid PET is used in the diagnosis of diffuse gliomas, with tracers that work on a protein basis (amino acids) and accumulate in brain tumors. Nathalie Albert explains: "PET imaging with radioactively labeled amino acids has proven extremely valuable in neuro-oncology and permits reliable representation of the activity and extension of gliomas. Although amino acid PET has been used for years, it had not been evaluated in a structured manner before now. In contrast to MRI-based diagnostics, there have been no criteria for interpreting these PET images." According to the researchers, the new criteria allow PET to be used in clinical studies and everyday clinical practice and create a foundation for future research and the comparison of treatments for improved therapies.
The Response Assessment in Neuro-Oncology (RANO) Working Group is an international, multidisciplinary consortium founded to develop standardized new response criteria for clinical studies relating to brain tumors. Comprising experts from various fields, the group has been developing criteria to serve as standard references for assessing various clinically relevant aspects for more than a decade.
Diffuse gliomas are malignant brain tumors that cannot be optimally examined by means of conventional MRI imaging. So-called amino acid PET scans are better able to image the activity and spread of gliomas. An international team of researchers (RANO Working Group), led by scientists from LMU and the Medical University of Vienna, has now drawn up the first ever international criteria for the standardized imaging of gliomas using amino acid PET.
The Department of Diagnostic Imaging, a recipient of the Quantitative Imaging Excellence (CQIE) designation, is the only broad-based pediatric radiology program committed largely to childhood cancer. Diagnostic Imaging has a fundamental role in improving the quality of patient care and outcomes for children with catastrophic diseases. We function in four sections: Body Imaging, Neuro Imaging, Interventional Radiology, and Nuclear Medicine. Our focus on exceptional and specialized imaging via multiple modalities to guide diagnosis and therapy monitoring is balanced with a drive to explore research technologies that enhance diagnostic accuracy. Our research endeavors span multiple facets of imaging: functional MRI (fMRI), spectroscopy, metabolic imaging, a growing Interventional Radiology section, as well as preclinical development of new imaging techniques. The department also offers a variety of education opportunities to support both new and experienced physicians.
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Tumors of the central nervous system are the most common solid malignancies in children and the most common cause of pediatric cancer-related mortality. Imaging plays a central role in diagnosis, staging, treatment planning, and response assessment of pediatric brain tumors. However, the substantial variability in brain tumor imaging protocols across institutions leads to variability in patient risk stratification and treatment decisions, and complicates comparisons of clinical trial results. This White Paper provides consensus-based imaging recommendations for evaluating pediatric patients with primary brain tumors. The proposed brain magnetic resonance imaging protocol recommendations balance advancements in imaging techniques with the practicality of deployment across most imaging centers.
Computed tomography (CT) and magnetic resonance imaging (MRI) have revolutionized the study of the brain by allowing doctors and researchers to look at the brain noninvasively. These diagnostic imaging techniques have allowed for the first time the noninvasive evaluation of brain structure, allowing doctors to infer causes of abnormal function due to different diseases.
Northwestern Medicine offers the latest advances in diagnostic imaging, a skilled team of caring specialists and comprehensive services that are fully coordinated with your medical care. Your care is backed by:
Our diagnostic imaging technologists have many years of experience in the field. The radiologists who interpret your exams hold subspecialty training in areas such as neuroradiology and interventional radiology.
In the spirit of keeping you well-informed, some of the physician(s) and/or individual(s) identified are neither agents nor employees of Northwestern Memorial HealthCare or any of its affiliate organizations. They have selected our facilities as places where they want to treat and care for their private patients.
Fluorescence-guided surgery is a state-of-the-art approach for intraoperative imaging during neurosurgical removal of tumor tissue. While the visualization of high-grade gliomas is reliable, lower grade glioma often lack visible fluorescence signals. Here, we present a hybrid prototype combining visible light optical coherence microscopy (OCM) and high-resolution fluorescence imaging for assessment of brain tumor samples acquired by 5-aminolevulinic acid (5-ALA) fluorescence-guided surgery. OCM provides high-resolution information of the inherent tissue scattering and absorption properties of tissue. We here explore quantitative attenuation coefficients derived from volumetric OCM intensity data and quantitative high-resolution 5-ALA fluorescence as potential biomarkers for tissue malignancy including otherwise difficult-to-assess low-grade glioma. We validate our findings against the gold standard histology and use attenuation and fluorescence intensity measures to differentiate between tumor core, infiltrative zone and adjacent brain tissue. Using large field-of-view scans acquired by a near-infrared swept-source optical coherence tomography setup, we provide initial assessments of tumor heterogeneity. Finally, we use cross-sectional OCM images to train a convolutional neural network that discriminates tumor from non-tumor tissue with an accuracy of 97%. Collectively, the present hybrid approach offers potential to translate into an in vivo imaging setup for substantially improved intraoperative guidance of brain tumor surgeries.
Volunteers are needed for clinical trials that are exploring new ways to detect dementia early. By joining one of these studies, you may learn more about the biological signs of dementia and contribute useful information to help diagnose and treat dementia.
Biomarkers are also an important part of dementia research. They help researchers detect early brain changes, better understand how risk factors are involved, identify participants who meet particular requirements for clinical trials and studies, and track participants' responses to a test drug or other intervention, such as physical exercise. The following information notes how some of these biomarkers are used for research purposes, in addition to diagnosis.
MRI uses magnetic fields and radio waves to produce detailed images of body structures, including the size and shape of the brain and brain regions. Because MRI uses strong magnetic fields to obtain images, people with certain types of metal in their bodies, such as a pacemaker, surgical clips, or shrapnel, cannot undergo the procedure.
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