Resting-State Functional MRI in Glioma Patients Before and After Surgery

M.D. Anderson Cancer Center29 enrolled

Overview

This clinical trial studies how well resting-state functional magnetic resonance imaging (MRI) and cerebrovascular reactivity (CVR) MRI performed before and after surgery works in measuring the effects on language in patients with glioma. Mapping language function before brain tumor resection is crucial for preventing post-surgical deficits and maximizing restoration of language function following surgery. Additional imaging, such as resting-state functional MRI and CVR MRI, may help measure the language network in the brain before surgery and any effects on language function after surgery.

PRIMARY OBJECTIVES: I. To develop a reliable platform for preoperative mapping of language networks using resting-state-functional magnetic resonance imaging (rs)-fMRI in glioma patients. SECONDARY OBJECTIVES: I. To explore the reorganizations of resting-state functional connectivity (FC) and their relation to neuropsychological outcomes in glioma patients after surgery. OUTLINE: Patients undergo standard of care functional (f)MRI, CVR MRI over 3 minutes, and rs-fMRI over 6 minutes 1 month before and within 6 weeks after standard of care surgery. After completion of study, patients are followed up at 4-6 weeks.

Study Type

INTERVENTIONAL

Allocation

Purpose

DIAGNOSTIC

Masking

NONE

Enrollment

Conditions

Brain Mass Glioma

Eligibility

Sex: ALLMin age: 18 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Patients with newly diagnosed brain mass suspected to be gliomas * English speaker * Right handed * Tumor is located on or adjacent to Broca's or Wernicke's areas in the hemisphere suspected to be dominant for language * No prior history of neurologic disease or insult, or neuropsychiatric illness requiring treatment that would affect cognition in the opinion of the attending neuropsychologist * Patients who will undergo neurosurgical resection * Patients who are on neurosurgical evaluation will undergo direct cortical stimulation (DCS) as standard of care * Patients who will complete pre- and postoperative neuropsychological testing per standard of care * Pregnant women Exclusion Criteria: * Patients with prior radiation or chemotherapy * Patients cannot give informed consent * Patients cannot undergo MRI and functional MRI examinations

Outcomes

Primary Outcomes

Detectability of language networks

Will be performed using resting-state-functional magnetic resonance imaging (rs-fMRI). The receiver operating characteristic (ROC) analysis will be carried out to compare the difference between the diagnostic performance of the proposed method and that of the data-driven rs-fMRI method. The study will evaluate the performance of rs-fMRI by comparing with the standard of care intraoperative direct cortical stimulation.

Time frame: Up to 6 weeks

Secondary Outcomes

Changes in resting-state functional connectivity and neuropsychological outcomes

Graph theoretical analysis and large-scale network analysis will be applied to analyze pre- and post- surgical rs-fMRI data, to explore how the functional reorganization is correlated to the changes of neuropsychological scores. Correlational analyses will be conducted to determine the associations between changes in rs-fMRI network features and neuropsychological functioning from the pre- to postoperative period.