Eric A. Mellon, MD, PhD, co-chair of the Sylvester Cancer Site Neuropathology Group, associate professor of radiation oncology and biomedical engineering at the Miller School, and grant co-principal investigator

A collaborative project with Emory University will improve the groundbreaking spectral MRI technology to make it easier to use.

Researchers at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine will share a five-year, $3.3 million NIH grant with Emory University to study spectral magnetic resonance imaging (sMRI) and facilitate its use. This advanced imaging tool can help doctors detect glioblastoma, an extremely deadly brain tumor.

Spectral MRI, developed mostly at the University of Miami, is a way to detect metabolites in the brain and create maps of those metabolites. We know that glioblastomas have a specific metabolic change that makes them detectable by spectral MRI, revealing hidden cancers that other techniques can’t find.”

Eric A. Mellon, MD, PhD, co-chair of the Sylvester Cancer Site Neuropathology Group, associate professor of radiation oncology and biomedical engineering at the Miller School, and grant co-principal investigator

With a five-year survival rate of less than 10%, glioblastoma is one of the deadliest cancers. These tumors can be particularly challenging because they are difficult to locate and treat completely. As a result, small leftovers can seed the brain for a future relapse. Spectral MRI gives doctors a better tool to see more cancers and remove them surgically or kill them with radiotherapy.

Read on for what’s really going on

For Dr. Mellon, a radiation specialist, MRI can expand its ability to provide more comprehensive treatment, increasing radiation doses to newly discovered tumor sites. Even at higher doses, healthy brain tissue can tolerate radiation better than tumors. But first, radiation oncologists must locate all cancers -; Magnetic resonance imaging (sMRI) could be the answer.

“Theoretically, spectral MRI could provide a signature of every chemical in the brain, which is essentially what a surgical biopsy can do,” said Suleiman Sharif, senior project manager on Sylvester’s sMRI team. “This is what spectroscopy can provide: a readout of what’s really going on in the brain.”

However, the same accuracy that makes MRI a powerful tool for detecting brain tumors also makes it difficult to deploy. This technology produces large multi-gigabyte files that must be processed and interpreted, which is a significant computational effort. As a result, only a few cancer centers, such as Sylvester, Emory and Johns Hopkins, have these abilities.

“The grant is about increasing the usability of this technology so more institutions can adopt it,” said Dr. Mellon. “Data acquisition and processing requires significant training and experience. We are working with scanner manufacturer Siemens to simplify the process as much as possible. Ideally, manufacturers will integrate it into their scanners, and teams with less training can just push a button.”

Improve detection and treatment

The research team has already made significant progress, reducing processing times from hours to minutes. They have adopted advanced computational approaches to reduce those times even further.

“We are taking a process that was purely statistical and iterative and applying deep learning,” Sharif said, referring to one of the key steps of the process, which is also the most time and computation intensive. “We can now process these files in about a minute or even seconds, getting equal and sometimes even better results.”

This work is consistent with several clinical trials that Dr. Mellon and colleagues are conducting to improve detection and treatment of glioblastoma. A recent study by Sylvester, Emory, and Johns Hopkins showed that increased radiation doses, obtained through magnetic resonance imaging, improved patient survival. The researchers plan to conduct a larger follow-up study to validate these findings.

Dr. Mellon is also enrolling patients in a clinical trial that combines the anti-cancer drug Avastin with proton radiation, which can focus more precisely on tumor tissue, leaving relatively healthy cells relatively unscathed. The sMRI readout will be necessary to expand treatment areas and hopefully eliminate all cancer cells.

“Using spectral MRI guidelines, we want to treat as much of the disease as possible to improve survival,” said Dr. Mellon. “Radiation oncologists have been reluctant to apply higher doses because of potential side effects. But glioblastoma kills everyone it hits. We have to push the envelope.”

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