3T MRI of Intramedullary Spinal Cord Tumours
Research type
Research Study
Full title
Multimodal MRI to Differentiate Subtypes of Intramedullary Spinal Cord Tumours: A Pilot Study
IRAS ID
288270
Contact name
Yazhuo Kong
Contact email
Sponsor organisation
University of Oxford / Clinical Trials and Research Governance
Duration of Study in the UK
1 years, 6 months, 0 days
Research summary
Intramedullary spinal cord tumours (IMSCTs) are a type of tumour that arises from cells within the spinal cord. They are rare, accounting for 4-10% of central nervous system tumours. They commonly present as back/neck pain and have poor outcomes if not treated.
IMSCTs fall into various subtypes. Around 90% are either ependymomas or astrocytomas. Ependymomas are usually quite distinct from the surrounding tissue and therefore can often be treated successfully with surgery. In contrast, astrocytomas tend to invade the surrounding tissue and so generally cannot be entirely surgically removed and radiotherapy is recommended instead. Unfortunately, ependymomas and astrocytomas can appear very similar on diagnostic scans and are difficult to tell apart pre-surgery. Biopsy remains the gold standard for tumour subtype differentiation.
Any spinal cord surgery, whether it be biopsy or resection, poses major challenges due to the small size of the spinal cord. A small corridor via the back of the spinal cord, known as the posterior midline, usually offers the safest approach to a tumour. However, finding this access corridor can be very difficult because tumours tend to deform the anatomy of the spinal cord, leading to a high risk of injury to the normal spinal cord tissue or nerves.
The primary objective of this pilot study is to test if cutting-edge spinal cord magnetic resonance imaging (MRI) techniques could help to better differentiate between tumour subtypes. Our second objective is to see if these MRI techniques could help to identify the location of the posterior midline. Additionally, we want to investigate the relationship between imaging metrics and patient pain and sensorimotor symptoms.
We hope the results of this study could inform a larger trial to fully assess the utility of cutting-edge MRI techniques for reducing both the need for spinal cord surgery and the risks associated.
REC name
London - Brent Research Ethics Committee
REC reference
21/LO/0298
Date of REC Opinion
7 Apr 2021
REC opinion
Favourable Opinion