Magnetic resonance imaging (MRI) is widely used both in the clinic and as a research tool in the management of brain tumours. While most studies focus on adult tumours, which have a higher incidence than those in children, paediatric brain tumours differ widely in terms of biology and treatment management. Furthermore, as a non-invasive and non-ionising imaging tool, MRI is used in the diagnosis, prognosis and assessment of treatment response of such tumours. This work focuses on diffusion MRI to study childhood brain tumours. The thesis is divided into three main parts: a reproducibility study of diffusion MRI parameters in order to answer the question of whether clinical imaging may be used interchangeably across multiple-centres to combine data from different institutions; a study on a tumour border diffusion measure as a prognostic biomarker in children with embryonal brain tumours – the apparent transient coefficient in tumour (ATCT); and a study analysing the functional diffusion map (fDM) as a tool for assessing treatment response in paediatric brain tumours. Diffusion MRI has been shown to have a good reproducibility and thus data from multiple centres and scanners can be combined in order to analyse clinical data for patients treated at different institutions; particularly where data for specific tumour types would otherwise be limited. In addition, ATCT has been shown to be a useful prognostic biomarker in children with embryonal brain tumours. Finally, while the fDM may be beneficial in assessing treatment response, the underlying biology of both tumour and healthy tissue needs to be carefully considered, and in particular, areas of necrosis, tumour grade and change in tumour size need to be taken into account. In conclusion, diffusion MRI is a valuable tool in the management of childhood brain tumours, with multi-centre studies paving the way for further research and validation of biomarkers.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:626528 |
| Date | January 2014 |
| Creators | Grech Sollars, M. |
| Publisher | University College London (University of London) |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://discovery.ucl.ac.uk/1430180/ |
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