MRI Perfusion Compared to FDG PET/CT in Distinguishing between Radiation Injury and Tumor Progression in Patients with Cancer in the Brain Treated with Radiation Therapy

Status: complete

This clinical trial compares magnetic resonance imaging (MRI) perfusion to fludeoxyglucose F 18 (FDG) positron emission tomography (PET)/computed tomography (CT) to see how well they work in identifying the difference between brain damage caused by radiation therapy and tumor growth in patients who have received radiation therapy to the brain for a brain tumor or cancer that has spread from another part of the body. MRI perfusion uses an injected dye to study the blood vessels in the tumor. FDG PET/CT combines PET and CT scans to study how quickly tumor cells are growing. It is not yet known whether MRI perfusion or FDG PET/CT is more effective at distinguishing between brain damage and tumor growth.

Inclusion Criteria

Pathological or clinical/radiological diagnosis of a neoplasm, either primary (e.g., malignant glioma) or secondary (metastasis from systemic malignancy) with a history of brain radiation therapy
Completed fractionated radiation therapy (to 60 Gy for high grade gliomas) or stereotactic radiosurgery or hypofractionated radiation therapy (e.g. for brain metastases, anaplastic meningiomas), without or with concurrent chemotherapy
New or increased enhancing brain lesion(s) OR nonenhancing brain lesion(s) if receiving anti-angiogenic therapy, which is considered indeterminate for tumor progression versus (vs) radiation injury by the neuroradiologist or clinician
Patient and/or guardian is able to provide written informed consent prior to study registration

Exclusion Criteria

Claustrophobia
Known allergic reaction to diethylene triamine pentaacetic acid (Gd-DTPA)
Any contraindication to gadolinium intravenous contrast as per standard Department of Radiology contrast guidelines
Any contraindication to MRI (e.g., pacemaker, aneurysm clip, tissue expander)
Pregnant or nursing female
Unable to cooperate for MRI and/or PET/CT

PRIMARY OBJECTIVE:

I. To directly compare PET/CT with MRI perfusion in distinguishing between radiation injury and tumor progression.

OUTLINE:

Patients receive gadolinium intravenously (IV) and undergo perfusion MRI, and receive FDG IV and undergo PET/CT. Scans should take place as close as possible and on the same day or same week if feasible, but no more than 12 weeks apart.

After completion of study, patients are followed up every 2-3 months for up to 1 year.

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MRI Perfusion Compared to FDG PET/CT in Distinguishing between Radiation Injury and Tumor Progression in Patients with Cancer in the Brain Treated with Radiation Therapy

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