Medical imaging is used in many stages of brain tumor treatment, including diagnosis, surgical and radiation planning, as well as long term clinical follow-up for monitoring treatment response and tumor progression. Medical imaging, specifically MRI, has become so standard to clinical care in recent years that it sometimes is neglected as an area needing improvement.
MRI “contrast enhancement” is currently the clinical standard for defining the margins of high-grade brain tumors. This brightening of the MR image occurs when injected contrast agent leaks from the blood vessels into tumor-disrupted tissue. Though this imaging is effective at initial diagnosis, treatment such as surgery, radiation, and chemotherapy can also disrupt brain tissue allowing contrast agent leakage. This complicates clinical interpretation.
At the Medical College of Wisconsin, we are at the forefront of brain cancer MRI research. Our current research studies are aimed at improving detection of infiltrative brain tumor cells into surrounding healthy brain, detecting changes in abnormal brain tumor vasculature, and better assessing tumor response to therapy. Central to these research aims is the creation and calibration of new medical imaging techniques meant to improve our imaging capabilities beyond current technology.
Together with Dr. Kathleen Schmainda’s lab in the departments of Biophysics and Radiology at MCW, we study the histology underlying our newly developed imaging techniques. To accomplish this we document the location of brain tumor samples surgically removed by our neurosurgeons with the state-of-the-art surgical navigation equipment they utilize during surgery. This study has given us the ability to determine the underlying histological tumor characteristics that manifested themselves on the imaging acquired prior to surgery. This has helped us better understand what the imaging said about the true nature of the tumor removed. Additionally, tumor samples have been banked for future histological study.
In addition to this study we have been both honored and humbled by several patients approaching our neuro-oncologist Dr. Jennifer Connelly about donating their brain to research following their fight with brain cancer. Members of our pathology department perform brain only autopsies giving us the unique opportunity to precisely measure and correlate the true histology underlying imaging at an unprecedented level of accuracy. Their willingness to participate has given us the ability to calibrate our imaging techniques to better help future patients and those currently undergoing treatment. This research project was recognized internationally with an award at the annual meeting of the International Society of Magnetic Resonance Imaging in Medicine in Melbourne, Australia, and locally we were given the top award for non-basic research at the annual MCW Faculty Research Day. The unique combination of our brave patient population, and the clinicians and researchers at the Medical College of Wisconsin have made our brain tumor imaging program truly world renowned.
More information about Dr. LaViolette can be found on his Google Scholar page.
Center for Imaging Research | Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226 | (414) 955-4663