# Multimodality Neuroimaging Evaluation of Cognitive Functioning in Lower Grade Astrocytoma

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $658,612

## Abstract

PROJECT SUMMARY
Survival outcomes for patients with lower grade gliomas continue to improve as diagnosis and treatment
evolve. However, damage caused by tumor growth and by the consequences of treatment often leads to
significantly impaired cognitive function. Our previous work has demonstrated that radiation therapy reduced
ratios of N-acetyl-aspartate (a neuronal biomarker) levels to creatine derive from proton-1 MR spectroscopic
imaging within the normal-appearing white matter. This steady state metabolic imaging also provides other
metabolic parameters to differentiate tumor cells from normal brain, detect the presentence of IDH mutation
and predict survival in lower grade glioma. In addition, stable and treatment-free lower grade glioma had
impaired cognition and quality of life, with the severity associated with the history of treatment and the volume
of T2 lesions. These results suggest that the use of multiparametric MRI could improve tumor delineation,
identify patients at risk for specific deficits and provide an opportunity for intervention. The objective of this
translational proposal is to utilize a novel multimodality MR protocol, which integrates dynamic and steady
state MR metabolic imaging with diffusion, perfusion, and resting-state functional MRI to provide quantitative
metrics on dynamic and steady-state metabolism, white matter integrity, blood volume, and functional
networks, to evaluate cognitive functioning and quality of life in patients with lower grade astrocytoma. We will
take advantage of our unique experience in proton-1 MR spectroscopic imaging, which has been implemented
into routine clinical examinations, and hyperpolarized carbon-13 pyruvate imaging, where we performed the
first-in-human [2-13C]pyruvate study to image real-time glycolysis and oxidative metabolism simultaneously, to
assess tumor burden, cognitive functioning, and quality of life. Once the multimodality MR protocol has been
established in Aim 1, we will evaluate the normal and abnormal brain changes during radiation therapy and
then correlate these changes to impairments in cognitive functioning and quality of life in Aim 2. Aim 3 will
examine signatures associated with recurrent tumors and evaluate the impact of tumor burden on cognition
and quality of life. The results of the proposed study will be critical for assessing response to treatment,
developing effective treatment strategies, and improving quality of life. Ultimately, it will provide effective
clinical management of patients and aid neuro-oncologists in making timely decisions.

## Key facts

- **NIH application ID:** 10498714
- **Project number:** 1R01CA273028-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Jeremy William Gordon
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $658,612
- **Award type:** 1
- **Project period:** 2022-09-09 → 2027-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10498714

## Citation

> US National Institutes of Health, RePORTER application 10498714, Multimodality Neuroimaging Evaluation of Cognitive Functioning in Lower Grade Astrocytoma (1R01CA273028-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10498714. Licensed CC0.

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