Many childhood brain tumour patients currently have low prognosis. The introduction and combination of new non-invasive MRI techniques to investigate tumour micro-environment may hold the key to increasing the accuracy of determining prognosis and treatment response. Diffusion weighted magnetic resonance imaging (DWI) provides information on the cellularity of tissue based on the mean apparent diffusion coefficient (ADC), and this has been used to describe tumour tissue structure. More recently the mean ADC has been shown to be the combination of different components, fast and slow, and these components may give more insight into tissue structure than ADC alone. Magnetic Resonance Spectroscopy (MRS) provides information of metabolites within the tissue, and metabolite profiles have been shown to be a strong characteristic of brain tumour type. However MRS can also be used to probe tissue micro-environment, such as temperature, and this provides another means of investigating tumours. The relative change in metabolite concentrations over different MRS echo times can be used to measure the relaxation properties (T2) and which are dependent upon molecular environment. The combination of these measurements to provide increased prognosis accuracy and measure treatment response will be investigated. The combination of MRS and DWI for diagnosis potential has been investigated, however using micro-environmental probes, diffusion components, temperature and T2 relaxation, is novel and will provide vital information gained non-invasively, which will potentially change patient treatment and outcomes. The study proposed aims to assess the tumour micro-environment thoroughly through MRS and DWI.
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