Merit of MRI Perfusion Targets for Radiotherapy Planning

DESCRIPTION (provided by applicant): The goal of this Phase I STTR proposal is to seamlessly integrate MRI (magnetic resonance imaging)- derived perfusion measurements into the radiation treatment (RT) planning systems for brain tumor patients. Currently the MRI and CT (computed tomography) information that is used to define the RT target volumes is based on information about brain anatomy, and not tumor pathophysiology. This continues to be the case even though new perfusion-based MRI methods have demonstrated great promise in predicting the success of radiation treatments, aiding in the discovery and optimization of new treatment strategies and decreasing morbidity. These advanced imaging techniques have not been translated into the clinic since there is no efficient way to process, display and integrate these technologies into a useable platform available for radiation planning. Consequently, the key to realizing the full clinical and commercial potential of such techniques is the development of an integrated display and analysis platform with an output that is useful for RT planning. Such a platform is under development at the newly formed company, SPUD Imaging Inc. One output of this platform will be contours generated from a multi-parameter perfusion data set, which is obtained with a novel combined gradient-echo(GE)/spin-echo(SE) MRI sequence. With this patented approach, we are able to provide measurements of cerebral blood volume (CBV) and cerebral blood flow (CBF), sensitive to either the entire population of vessels (GE) or the microvascular vessel population (SE), measures of the mean vessel diameter (mVD), mean transit times (MTTs) and transit time distributions (TTDs). Though we are now obtaining these physiologic imaging maps routinely for research purposes, there is currently no way to interface such physiologic data with the RT planning systems. This STTR application addresses this issue by proposing to refine and optimize code to post-process the unique perfusion data, develop a prototype viewer to display the critical quantitative and spatial relationships between the physiologic and anatomic parameters (milestone 1), and output the data in a manner compatible with radiation planning platforms (milestone 2). Upon completion of the proposed studies there will exist a prototype technology that enables the performance of clinical feasibility studies, to determine differences in outcome when using perfusion targets for radiation planning (Phase II).