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Investigation of Tissue Micro-environments

Investigation of Tissue Micro-environments using Diffusion Magnetic Resonance Imaging’ 2019

University of Birmingham and Birmingham Children’s Hospital

Poppy had been diagnosed with a brain tumour (glioma) at only 14 months old. The brain scan revealed a huge mass the size of an orange. Twelve days post diagnosis Poppy had an 8 hours brain surgery. Her mum said “we were told there was only a 50/50 change we would get her back”

Typically, these tumours are slow growing, however Poppy’s tumour followed a very aggressive course – this was not expected by her consultants.The Glioma can then press and squeeze parts of the brain near the chiasm. This can lead to other conditions developing including hydrocephalus, problems with growth and development.

In January 2021 Poppy reached the milestone age of 18, an amazing achievement from the initial prognosis. Over the years Poppy has had 5 brain surgeries, 2 years of chemotherapy, 6 weeks of radiotherapy, over 70 MRI scans and countless other procedures. The brain tumour and treatment have taken Poppy’s sight in her right eye and left her with many other lifelong issues and some tumour still remains. However, Poppy is full of positivity and happiness and lives her life to the fullest.

New research has now been developed to help children like Poppy. A biopsy of Poppy’s tumour was used in the research together with 113 biopsies from children’s brain tumours and tracked over a 5 year period. Poppy was fortunate to have such a positive outcome. Sadly, some children died as a result of the cancer treatments.

Read the latest research led by Poppy’s paediatric consultant Prof Andrew Peet

Poppy’s paediatric consultant Prof. Andrew Peet said ‘Her tumour 100% did not behave how we thought it was going to. The quality of information at that time was poor. If we’d known these things back when we started treating her it would’ve been so useful.

 

PROJECT: Investigation of Tissue Micro-environments using Diffusion Magnetic Resonance Imaging’ 2019

LED BY: Professor Andrew Peet, Children’s Brain Tumour Research Team, University of Birmingham and Birmingham Children’s Hospital.

SUMMARY:  A new scan that predicts how fast tumours grow will spare children from receiving unnecessarily aggressive cancer treatments. This aims to provide a quicker way to identify and assess the characteristics of childhood tumours. Until this study accurately predicting how the tumour will progress in individual children has proved a challenge. There is a strong need to individualise cancer treatments for young children who are the most vulnerable to side effects from aggressive treatments.

The Children’s Brain Tumour Research Team used biopsies from 114 child brain tumours and tracked them over a 5 year period. At the end of the study in 2019, 79 children were surviving, 35 died.

RESULTS: Via an MRI scan concentration of the chemical glutamine and lipids  were accurately measured. (The research showed that a high level of lipids (fat levels) indicated an aggressive tumour. High levels of the chemical glutamine were strong indicators of a slow growing tumour.The results indicated the significant advantage of individualising treatments to the needs of the child. This is predicted to improve survival rates.

Professor Andrew Peet who leads the team said  “This is a huge step forwards towards the introduction of more personalised treatment for childhood brain tumour patients,” Assessing how aggressive these tumours are at an earlier stage will help ensure that treatment is no more toxic than it needs to be, reducing the adverse effects on patients and improving their quality of life.”

Ian Walker, Cancer Research UK’s director of clinical research, said: “This important research shows that looking at the molecules produced by cancer cells’ metabolism could offer a promising new way to predict how well some children with brain tumours might respond to treatment or whether their cancer is likely to come back.

“We urgently need a better understanding of these hard-to-treat tumours so that doctors can consider prescribing additional treatments or enrolling children in clinical trials of new treatments earlier on, giving them the best chance of survival.”

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