# Improved whole-brain spectroscopic MRI for radiation therapy planning

> **NIH NIH U01** · EMORY UNIVERSITY · 2023 · $601,791

## Abstract

Identifying the extent of brain tumor margins for radiation treatment planning remains a challenging task due to
the infiltrative nature of these tumors and limitations in current standard imaging methods. Multiple studies
including our own have demonstrated that an MR technique for detecting metabolites in tissue, MR spectroscopic
imaging or spectroscopic MRI (sMRI), can detect areas of infiltrating tumor with a high degree of sensitivity and
specificity, enabling better radiation treatment of areas that lead to early recurrence and extending life. sMRI
enables the identification of tumor extent that is marked by increased Choline/N-Acetylaspartate ratios, including
regions that are not detectable by diagnostic MRI and that are normally left untreated. By allowing these
previously undetected regions to be treated, sMRI has the potential to improve the efficacy of radiation treatment
and significantly delay recurrence. In our 3-site sMRI-guided radiation dose escalation pilot study which was
completed in 2019, we were able to demonstrate feasibility and safety. Survival analysis of all 30 GBM patients
shows a promising median overall survival (OS) of 23 months compared to 16 months OS for GBM patients
receiving standard-of-care. Our trial has been approved as a National Clinical Trial Network (ECOG-ACRIN)
trial (EAF211). This is a great opportunity to disseminate this technique with staff support from ACRIN and
American College of Radiology (ACR). We will achieve the goal in the renewal funding period of our current
project by leveraging diverse expertise at three research sites and collaboration with Siemens Healthineers to
engineer and validate technological improvements needed to improve sMRI acquisition, analysis, and clinical
integration. These improvements include: (1) updated rapid and motion-robust sMRI for improved image quality;
(2) new accelerated data processing pipelines to return Cho/NAA ratio maps to PACS for clinically timely
radiology reporting; (3) new processing, display, and analysis methods that will present metabolite maps in an
efficient manner with a clinician-friendly interface that enables integration with radiation treatment planning
software systems; and (4) development of new tools to predict the optimal baseline RT planning strategies using
sMRI. The completion of this study will provide robust sMRI acquisition methods and software tools that are
ready to be deployed in clinical use and which will help guide important treatment decisions.

## Key facts

- **NIH application ID:** 10618320
- **Project number:** 5U01CA264039-05
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Lee Cooper
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $601,791
- **Award type:** 5
- **Project period:** 2022-05-05 → 2027-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10618320

## Citation

> US National Institutes of Health, RePORTER application 10618320, Improved whole-brain spectroscopic MRI for radiation therapy planning (5U01CA264039-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10618320. Licensed CC0.

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