Standardized brain tumor imaging protocols for clinical trials: current recommendations and tips for integration

Francesco Sanvito; Timothy J Kaufmann; Timothy F Cloughesy; Patrick Y Wen; Benjamin M Ellingson

doi:10.3389/fradi.2023.1267615

Standardized brain tumor imaging protocols for clinical trials: current recommendations and tips for integration

Front Radiol. 2023 Dec 13:3:1267615. doi: 10.3389/fradi.2023.1267615. eCollection 2023.

Authors

Francesco Sanvito^{1

2}, Timothy J Kaufmann³, Timothy F Cloughesy^{4

5}, Patrick Y Wen⁶, Benjamin M Ellingson^{1

2

7

8

9}

Affiliations

¹ UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers, University of California, Los Angeles, Los Angeles, CA, United States.
² Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
³ Department of Radiology, Mayo Clinic, Rochester, MN, United States.
⁴ UCLA Neuro-Oncology Program, University of California, Los Angeles, Los Angeles, CA, United States.
⁵ Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
⁶ Center for Neuro-Oncology, Dana-Farber/Brigham and Women's Cancer Center, Harvard Medical School, Boston, MA, United States.
⁷ Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, United States.
⁸ Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
⁹ Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.

Abstract

Standardized MRI acquisition protocols are crucial for reducing the measurement and interpretation variability associated with response assessment in brain tumor clinical trials. The main challenge is that standardized protocols should ensure high image quality while maximizing the number of institutions meeting the acquisition requirements. In recent years, extensive effort has been made by consensus groups to propose different "ideal" and "minimum requirements" brain tumor imaging protocols (BTIPs) for gliomas, brain metastases (BM), and primary central nervous system lymphomas (PCSNL). In clinical practice, BTIPs for clinical trials can be easily integrated with additional MRI sequences that may be desired for clinical patient management at individual sites. In this review, we summarize the general concepts behind the choice and timing of sequences included in the current recommended BTIPs, we provide a comparative overview, and discuss tips and caveats to integrate additional clinical or research sequences while preserving the recommended BTIPs. Finally, we also reflect on potential future directions for brain tumor imaging in clinical trials.

Keywords: BTIP; RANO criteria; brain tumor imaging protocols; brain tumors; clinical trials; neuro-oncology; treatment response assessment.

Publication types

Review

Abstract

Publication types

Grants and funding