Histopathologic Evaluation of High Grade Brain Tumors by High Order Diffusion Tensor Imaging

Study Overview
=================
Brief Summary
-----------------
This study will examine the use of a variation of standard magnetic resonance imaging (MRI) called diffusion tensor MRI (DT-MRI), in order to evaluate the peripheral white matter infiltration of high grade brain tumors. Organized architecture is destroyed once brain tumor cells are infiltrating surrounding tissue. The infiltrated tissue is then isotropic (or less anisotropic). DT-MRI can assess anisotropy after datasets post treatment. Primary outcome is to find if a correlation exists between GA (generalized anisotropy) and the infiltration percentage of stereotactic peritumoral biopsies.

Detailed Description
-----------------
Patients with high grade brain tumor undergo a usual brain tumor MRI protocol as well as a 20 or 60 directions DT-MRI sequence upon patient collaboration. Images are acquired using a 3 Tesla MRI scanner (GE MR750 Discovery). The usual brain tumor MRI protocol contains the following sequences: 3DT1, Axial T2, Flair, T2 EG, diffusion (b0-b1000), 3DT1CE. They will then undergo stereotactic tumor biopsies with Leksell frame mounted. Biopsy targets will be surgically planned. The coordinates of this first biopsy will be recorded for later coregistration with DT-MRI datasets. Histopathologic analysis of the biopsies will be done using usual procedure. various immunologic markers such as MAP2, Ki67 will be used on the first biopsy sample in order to estimate the percentage of infiltration (ratio of tumor cells number over total cells number). Analysis of DT-MRI datasets will be done using home-made software for high order tensor resolution and GA estimation at the exact coordinates of the biopsy sites. Finally a statistical analysis (Pearson or Spearman) will be done to correlate GA and the infiltration percentage.

Official Title
-----------------
Histopathologic Evaluation of High Grade Brain Tumors by High Order Diffusion Tensor Imaging: Peritumoral Glial Cell Infiltration Quantitative Method

Conditions
-----------------
High Grade Brain Tumor

Intervention / Treatment
-----------------
* Other: peritumoral glial cell infiltration


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: - Patients with high grade brain tumor Age greater than 18 yo and under 85 yo Signed informed consent from patient Exclusion Criteria: -Any person with pacemaker, metal implant, claustrophobia, or any other contraindication for MR examination Severe renal failure Brain tumor biopsy contraindication

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Screening
Intervention Model: Single Group Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: brain tumor<br> | Other: peritumoral glial cell infiltration<br> <br> |

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| DTI-MRI |  | at J0 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Biopsy |  | at J+1 | 
| count cell |  | at J+10 | 
| datas co-registration |  | at J+20 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Glioma, Glioblastoma Multiform, Brain Cancer, Diffusion-Weighted Magnetic Resonance Imaging, High order diffusion tensor, Imaging guided biopsy, Histopathologic evaluation, Infiltration percentage, High grade brain tumor