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

Brief Summary

Detailed Description

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.

Primary Outcomes

Secondary Outcomes

• Distinguish spectroscopic patterns associated with tumor progression, necrosis and edema(at time of disease evaluation)
• Determine if early metabolic changes are predictive of response(at time of disease evaluation)