“Looking at Stars on a Dark Night” – New MRI Technique Doubles Brain Tumor Visibility

A new 3D technique with MRI scans can double the visibility of brain tumors when compared to existing visualization methods.

Developed at Northwestern University Feinberg School of Medicine, this technique has the potential to make it easier to treat these tumors by catching them at an earlier, smaller stage. Inventor and lead author Robert Edelman, M.D., clinical professor of radiology, shared his work in the Oct. 28 Science Advances.

“Our goal is for the new technique – T1RESS – to help thousands of patients by allowing malignant tumors to be detected at an earlier, more curable stage,” Edelman said.

Currently, 700,000 Americans are living with brain tumors, and according to the American Brain Tumor Association, 16,000 will die this year. Consequently, catching tumors earlier is critical to saving lives and improving outcomes. That is where this technique exhibits its benefit, he said. It can catch the very small malignant tumors that often escape notice with standard imaging techniques.

The hope, Edelman said, is that by making the tumor margins on contrast-enhanced scans more visible, providers will be better able to treat the entire tumor for patients undergoing surgery or radiotherapy, resulting in better clinical outcomes.

To determine how well T1RESS works, Edelman and his colleagues studied brain tumors in 54 patients. By applying the radio waves and magnetic fields used to generate MRI signals differently from existing imaging techniques, T1RESS uniquely manipulates brain tissue signals to produce images that offer significantly improved tumor visibility. Not only does this application method make T1RESS highly sensitive to the T1 shortening effects of paramagnetic contrast agents, but it also reduces the signal intensity of non-enhancing background tissues -- both of which improve tumor visualization.

Based on their analysis, the team found it provided a two-fold improvement over existing MRI methods in the contrast between tumors and normal brain tissue. Edelman likened the improved contrast effect to being better able to see stars at night than during the day.

"There just isn't enough contrast between the stars and the sunlit sky to make them visible," he said. "In the case of brain tumors, T1RESS doubles the contrast between tumors and normal brain, so the tumors are more easily detected. It's like looking at the stars on a dark night instead of on a sunny day."

These findings will need to be confirmed with a larger multi-site trial, he said, but the plan is to apply this technique to both prostate and breast cancers, as well. If the benefits are confirmed he said, widespread use will be as simple as the installation of a specialized software package.