Trial Information

A Pilot Study of 1H-Nuclear Magnetic Resonance Spectroscopic Imaging in Pediatric Patients With Primary and Metastatic Brain Tumors

Background:

- Brain tumors represent the most common solid tumor of childhood. Treatment generally
includes surgery and radiation, but recurrences are frequent, particularly for
high-grade lesions.

- Chemotherapy is often used in an adjuvant setting, to delay radiation therapy or for
resistant disease.

- Children with brain tumors are generally followed by imaging studies, such as CT or
MRI.

- Difficulty arises in trying to distinguish tumor regrowth from treatment related edema,
necrosis or radiation injury.

- Proton Nuclear Magnetic Resonance Spectroscopic (NMRS) Imaging is a non-invasive method
of detecting and measuring cellular metabolites in vivo.

Objective:

- To determine NMRS imaging patterns before, during and after chemotherapy in pediatric
patients with primary or metastatic brain tumors

- To identify and characterize specific patterns of metabolites related to tumor
regrowth, tumor response to therapy, edema or necrosis.

Eligibility:

- Age less than or equal to 21 years.

- Patients entered on this trial will also be entered on one of the Branch's primary
brain tumor treatment trials.

- Histologically confirmed primary or metastatic brain tumor. Patients with a brainstem
glioma or optic pathway gliomas are not required to have a histologic diagnosis.

- Measurable or evaluable tumor at the time of study entry.

Design:

- This is intended to be a pilot study to define metabolite patterns associated with
tumor growth, tumor edema and tumor necrosis as seen on standard MRI; and determine the
feasibility of using metabolite patterns to predict response to therapy in pediatric
patients with brain tumors.

- Contalateral spectroscopic analysis of normal appearing brain will also be performed
when feasible.

- Analysis of results will be stratified according to type of tumor, and prior history of
radiation therapy or surgery.