Derisking Imaging in Neuro-Oncology Trials

Overview
Perceptive is a leading imaging core lab with the experience and ability to provide a wide range of services involving neuroimaging in clinical trials. Our imaging scientists understand the unique and custom requirements of neuro-oncology trials and have the flexibility, creativity, bandwidth, and understanding in place to effectively manage and support these clinical trials.
In addition to standard MRI acquisitions, the use of advanced imaging techniques in neuro-oncology has been steadily increasing. Dynamic Contrast-Enhanced MRI (DCE-MRI) is being used to evaluate the microvasculature of glioblastomas to determine the effects of treatments on vascular permeability.
Diffusion Tensor Imaging (DTI) allows for the mapping of the orientation of white matter tracts. Both DCR-MRI and DTI, may be able to distinguish between different types of brain tumors, as well as other brain abnormalities. This can be helpful in assuring that the appropriate patients are enrolled in trials. Various Positron Emission Tomography (PET) techniques can also be used to target and evaluate the biological activity of the tumors.
Unique Features of Glioblastoma
Because of the biologic complexity of primary CNS tumors, there are many ways to use imaging to assess the magnitude of disease. Despite glioblastomas being solitary tumors, they often have different morphologies and may contain multiple regions in different stages of malignant degeneration. T2-weighted MRI can approximate the entirety of the tumor, whereas gadolinium-enhanced T1-weighted MRI can sensitively detect the regions of highest-grade malignancy.
The RANO criteria and iRANO for immunotherapies can be used to determine response to treatment for primary brain tumors and brain metastases but require significant clarifications to accomplish standardized approaches to central independent neuroradiology and neuro-oncology review and harmonization for investigators in multi-site studies.
Case Study
Clinical trial imaging in neuro-oncology trials often requires non-standard and custom procedures. In a recent glioblastoma multiforme trial that required a sponsor-initiated collaboration with an academic lab for DCE-MRI and DTI analysis, Perceptive created an efficient workflow that fulfilled both the academic lab’s and the sponsor’s needs. Trained Perceptive team members expertly processed both the DCE-MRIs and the DTI in a timely fashion and to the lab’s expectations. The sponsor utilized the data to accomplish some of the exploratory endpoints of the protocol. This workflow, coupled with the primary image processing and review handled by Perceptive contributed to the trial’s success.
Perceptive experience in brain metastasis studies
Perceptive Experience in primary brain tumor
Perceptive Experience in primary brain tumor
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