Readily Available MRI Technique Could Shed Light on Common Pediatric Cancer

An already available MRI technique could help providers determine whether a child has a particularly aggressive cancer, as well as pinpoint early whether a treatment is working, new research has revealed.

In a study published June 29 in Cancer Research, researchers from The Institute of Cancer Research in London described how using an MRI technique, called T1 mapping, could reveal critical details about neuroblastoma in children. It is the first study, the team asserted, to evaluate the benefit of this MRI technique as a “smart” cancer biopsy.

According to existing data, neuroblastoma is the most common cancer identified in children under age 1. It accounts for approximately 6 percent of pediatric cancers with 800 new cases diagnosed annually in the United States.

Although their work, to date, has been in studying neuroblastoma in mice, the investigators said the non-invasive T1 mapping scans could potentially have wide clinical applicability, allowing for treatments to be tailored to individual patients.

“Our findings show that an imaging technique readily available on most MRI scanners has the potential to pick out children with aggressive cancer and give us early signs of whether a treatment is working,” said lead study author Yann Jamin, Ph.D., Children with Cancer UK Research Fellow at the Institute of Cancer Research in London. “We’ve shown in mice that this technique can give us detailed insights into the biology of neuroblastoma tumors and help guide use of precision medicine, and next we want to assess its effectiveness in children with cancer.”

T1 mapping scans – studies that measure how water molecules interact at microscopic levels inside cells, offering a greater understanding of the cellular tissue composition – are currently used to analyze heart muscle tissue damage. In this study, the team used those T1 mapping MRI scans to map different tumor cell populations and compared them to maps created with artificial intelligence.

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They found that T1 values directly corresponded to changes in the aggressiveness of the cancer cells. High T1 value regions – where water molecules behave “more freely” – were locations of more aggressive cancer cells, and lower T1 value spots were more benign or even had dead tissue.

Targeted-Drug Testing

As an additional part of the study, investigators looked into whether T1 mapping could help them determine how mice with neuroblastoma responded to two drugs – alisertib and vistusertib – that target MYCN, a key protein linked to aggressive forms of neuroblastoma.

Given this analysis, they found that when the drugs succeeded in stopping tumor growth, T1 measures decreased, indicating the cancer cells had died. This outcome, they said, suggests that T1 measures could be a potential biomarker.

Based on the results of this study, the team said, the next step is to launch a clinical study to determine the benefit of T1 mapping in children.

“It’s vital that we find ways to improve treatments for aggressive childhood cancers like neuroblastoma,” said Paul Workman, Ph.D., chief executive of The Institute of Cancer Research, “and also that we spare children unnecessary side effects by minimizing exposure to drugs that do not seem to be working.”