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Work package 04

Functional imaging

Objectives
To use functional imaging for assessment of tumour volumes, regional lymph node involvement, tumour biology and monitoring of response to radiotherapy.
Description of work
Task 4.1. Experimental high field functional MRI. High field MRI will be utilized for high resolution imaging of oxygen levels, hypoxia, metabolism, and targeted nanoparticles. 19F oximetry is possible through the use of perfluorocarbon, and 19F-labelled hypoxia markers and FDG allows investigation of spatial distribution and kinetics of these tracers. 1H imaging will be utilized to detect USPIO particles with tumour-specific ligands.
Task 4.2. Optimisation of MRI and use of new nano particle contrast agents. Protocols will be developed to optimise geometric stability in DWI and DCE MRI data to be co-registered with anatomical images: standard T2 weighted MR, PET and CT. Novel USPIO contrast agents and first-pass tracer-kinetic techniques will be included in the clinical DCE-MRI implementation.
Task 4.3. Correlation of functional images with tumour biology. Functional imaging (DCE-MRI, DWI and PET-CT (18FAZA)) will be performed in patients with operable cervical cancer (stage IB) before radical hysterectomy. The pathological specimen will be subjected to both conventional and hypoxia specific immunohistochemical staining as well as autoradiograpy. MRI and PET-CT image information will be correlated with the histopathological findings.
Task 4.4. Repetitive imaging using MRI, PET-CT and CT perfusion. Repetitive functional biological imaging (DCE-MRI, DWI, PET-CT and perfusion CT) will be performed at the time of diagnosis and during radiotherapy in head&neck and uterine cervix cancer patients. Functional images will be compared and correlated to tumour topography and tumour regression during RT.
Task 4.5. Use of functional imaging to assess regional spread of disease. FDG-PET, DWI and MRI with administration of nano particle contrast agent (USPIO) will be performed in patient with operable rectal and gyneacological cancer. Lymph node dissection will be performed according to routine clinical practice. Sensitivity and specificity will be evaluated for lymph node assessment with FDG-PET, DWI and USPIO MRI.
Deliverables (projected outcome)
D4.1. Comparison of in vivo oxygen levels, hypoxia, and metabolism; and detection of targeted nanoparticles
D4.2. Optimal MR sequences for RT application will be developed
D4.3. Correlation between functional images and tumour biology will be assessed
D4.4. Functional imaging will be used to improve characterization of changes over time (during RT) of tumour biology and topography
D4.5. Evaluation of the ability of functional imaging to assess pathological lymph nodes