Gliomas are the most common primary brain tumour and result in significant morbidly and mortality. Diffuse low-grade gliomas are a subset with a propensity for slow, insidious growth; they almost inevitably undergo transformation into high-grade gliomas with resultant neurological dysfunction and death. We will examine the feasibility of using two magnetic resonance imaging (MRI) techniques in the management of gliomas: 1) multi-delay arterial spin labelled (ASL) MRI to measure blood flow and 2) amide proton transfer-weighted (APT) MRI to measure cellular protein content. These imaging measurements should identify regions of altered tumour physiology which are invisible on conventional images.
The management of low-grade gliomas relies on MRI biomarkers of tumour micro-vascularity to identify regions of likely transformation. Conventional assessment requires the administration of a contrast agent and is therefore not ideal given that patients may undergo serial surveillance imaging. ASL MRI offers assessment of microvascular parameters without contrast administration (1). The use of multiple labelling delays offers more robust quantification of perfusion parameters particularly in tumours with abnormal blood flow patterns. We will assess whether multi-delay ASL could replace the use of contrast agents (2) and also compare it to a novel contrast-sparing technique (3).
For many years, the aim of high-grade glioma surgery was the complete resection of ‘enhancing’ tumour – the part that appears bright after contrast agent inject. More recently, studies have evaluated ‘supra-total’ resections that also include non-enhancing tumour – reliable identification of non-enhancing tumour is critical to this approach but biomarkers are lacking. APT MRI is a novel technique that has been increasingly employed in glioma imaging to identify regions of active tumour. Initial studies have evaluated the role of APT imaging in glioma grading (4) and in differentiating tumour progression from treatment-related changes (5). We will explore the role of APT MRI in identification of the non-enhancing tumour, thus facilitating supra-total resection.
Entry Requirements:
Applicants are expected to hold (or about to obtain) a minimum upper second class undergraduate honours degree (or equivalent) in physics or engineering with a keen interest in biology and the brain. Research experience in imaging is desirable. A clinical radiology trainee with appropriate skills would also be considered.
For information on how to apply for this project, please visit the Faculty of Biology, Medicine and Health Doctoral Academy website (https://www.bmh.manchester.ac.uk/study/research/apply/). Informal enquiries may be made directly to the primary supervisor. You MUST also submit an online application form - choose PhD Biomedical Imaging Sciences.
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