SPectroscOpic prediction of bRain Tumours (SPORT): study protocol of a prospective imaging trial
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STUDY PROTOCOL
SPectroscOpic prediction of bRain Tumours (SPORT): study protocol of a prospective imaging trial Pamela Franco1,4* , Urs Würtemberger2,4, Karam Dacca4, Irene Hübschle4, Jürgen Beck1,4, Oliver Schnell1,4, Irina Mader3,4, Harald Binder4,5, Horst Urbach2,4 and Dieter Henrik Heiland1,4
Abstract Background: The revised 2016 WHO-Classification of CNS-tumours now integrates molecular information of glial brain tumours for accurate diagnosis as well as for the development of targeted therapies. In this prospective study, our aim is to investigate the predictive value of MR-spectroscopy in order to establish a solid preoperative molecular stratification algorithm of these tumours. We will process a 1H MR-spectroscopy sequence within a radiomics analytics pipeline. Methods: Patients treated at our institution with WHO-Grade II, III and IV gliomas will receive preoperative anatomical (T2- and T1-weighted imaging with and without contrast enhancement) and proton MR spectroscopy (MRS) by using chemical shift imaging (MRS) (5 × 5 × 15 mm3 voxel size). Tumour regions will be segmented and co-registered to corresponding spectroscopic voxels.Raw signals will be processed by a deep-learning approach for identifying patterns in metabolic data that provides information with respect to the histological diagnosis as well patient characteristics obtained and genomic data such as target sequencing and transcriptional data. Discussion: By imaging the metabolic profile of a glioma using a customized chemical shift 1H MR spectroscopy sequence and by processing the metabolic profiles with a machine learning tool we intend to non-invasively uncover the genetic signature of gliomas. This work-up will support surgical and oncological decisions to improve personalized tumour treatment. Trial registration: This study was initially registered under another name and was later retrospectively registered under the current name at the German Clinical Trials Register (DRKS) under DRKS00019855. Keywords: Radiogenomics, Magnetic resonance spectroscopy, MRS, MR spectroscopy, Chemical chift imaging, 1HMRS, MRI, Neuroradiology, Neurosurgery Background Gliomas are a very heterogenic group of tumours arising from glial cells in the central nervous system that are yet to be completely understood. Recent research advances have led to the characterization of different *Correspondence: pamela.franco@uniklinik‑freiburg.de 1 Department of Neurosurgery, Medical Centre, University of Freiburg, Breisacher Str. 64, 79106 Freiburg im Breisgau, Germany Full list of author information is available at the end of the article
tumour subgroups based on molecular properties and have shown the necessity to individualize patient treatment according to each tumour entity. As the revised classification of brain tumours by the World Health Organization of 2016 gave an essential role to the specific genetic alterations, not only for prognosis or probability of chemosensitivity, but also for the actual classification of tumours, determining the mo
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