Emory University: PIs: Hyunsuk Shim, Hui-Kuo Shu, Jeffrey J. Olson, Xiaoping P. Hu
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Transcript of Emory University: PIs: Hyunsuk Shim, Hui-Kuo Shu, Jeffrey J. Olson, Xiaoping P. Hu
Emory University: PIs: Hyunsuk Shim, Hui-Kuo Shu, Jeffrey J. Olson, Xiaoping P. HuCo-Inv: Tim Fox, Eduard Schreibmann, Chad A. Holder, Ying Guo, Andrew H. Miller, Daniel Brat, Alfredo Voloschin
Johns Hopkins University: PI: Peter Barker University of Miami: Consultant: Andrew MaudsleyCo-Inv: Matthias Holdhoff, Stuart Grossman, Doris Lin, Lawrence Kleinberg, Fausto Rodriguez
Quantitative MRSI to predict early response to SAHA therapy in GBM management
Pseudoprogression & Pseudoresponse
Reprograms tumor genes to carry out normal activity. Blocks abnormal HDAC and makes tumor DNA receptive to attack by temozolomide (TMZ).
Stops tumor growth & encourages tumor cells to behave more like normal brain cells
TMZ tumor cell killing is increased with SAHA
SAHA
+TMZSAHA opens up tumor DNA,
providing better access to TMZ
Technical Details: 32-channel phased-array head coil at 3T (Siemens)3D whole brain EPSI/GRAPPA (12 min scan time)TR/TE: 1550/17.6 ms, nominal voxel size: 4.4x4.4x5.6 mm3 (108 l)The internal water signal is collected as a denominator to obtain absolute metabolite concentrations in an interleaved manner, which does not increase the total scan time
Before Week 2 Week 11 Week 20
Gd-MRI
Cho/NAA ratio changes with SAHA+XRT+TMZ
Responder
Non-Responder
Trial design: New GBM
Before Week 2 Before Week 11
Gd-MRI
SAHA+TMZ+XRT
Wk 6
SAHA+TMZRest
Wk 20
MRSI MRSI MRSI
Clinical MRI Clinical MRI
Wk 0 Wk 11
Blobs Segmented TumorsF
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Multi-modality image registration (rigid & deformable) Quantitative tools for RT planning (SUV, Intensity
thresholding & clustering) Atlas-based segmentation methods for CT and MR Supports DICOM RT, CBCT, CT, MR, PET and SPECT FDA 510k Clearance Recent UCSF study found Velocity AI to have the smallest
mean spatial error out of 11 deformable image registration programs that were evaluated (Kirby et al. Med Phys 2013)
CCC = 0.995 ± 0.00295% CI = 0.990 - 0.997
CCC = 0.985 ± 0.00595% CI = 0.972 - 0.992
Dice = 0.916 ± 0.012 (CI95 = 0.891 - 0.940)MED = 0.142 ± 0.023 (CI95 = 0.096 – 0.188)
Dice = 0.640 ± 0.040 (CI95 = 0.559 – 0.722)MED = 3.110 ± 0.837 (CI95 = 1.411 – 4.811)
Pre-tumor resectionPre-tumor resection
Post-tumor resectionPost-tumor resection
Fuzzy 3 Computed Volume (cm3)
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Fuzzy 3 Computed Volume (cm3)
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3D NAAWhole Brain
Image co-registration platform
Unbiased-Tumor segmentation tool
Segmentation tool validation Concordance Correlation
Coefficient Dice Similarity Index Mean Euclidean Distance Bland Altman Plot
SAHA: Epigenetic Drug
SAHA
SAHA
Other applications of our tools
Guidance for stereotactic biopsy & surgery in Stealth Neuro-navigation System
Guidance for radiotherapy dose planning
Progress: Accepted PublicationsCordova et al. Translational Oncology 2014Shim et al. Am J Roentgenology 2014