Diffusion In Glioma (DIG) – an MRI clinical study

Fast facts

• Official title: Quantitative diffusion imaging for early treatment response and progression evaluation in adult high grade gliomas; a multicentre study (NCRI brain Clinical Studies Group, Imaging Subgroup)
• Lead researcher: Professor Adam Waldman
• Where: University of Edinburgh and Imperial College and NHS Trust, London
• When: October 2016 – January 2021
• Cost: £177,515
• Research type: Adult, Gliomas (High Grade), Clinical
• Grant round: NCRI Brain Tumour Imaging Subgroup

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Glioblastoma (GBM) is a highly aggressive brain tumour that’s particularly difficult to treat. Professor Adam Waldman from the University of Edinburgh is leading a group of neuro-oncology experts from five centres around the UK. The group is testing a new type of scan that will tell doctors quickly if a GBM is responding to treatment.

What is it?

The research group is using a specialised type of magnetic resonance imaging (MRI) scan, called diffusion weighted imaging (DWI). DWI measures the properties of water in the tumour and surrounding brain, and can detect a GBM responding to treatment much earlier than standard MRI can.

Adults taking part in the study will be given an MRI scan and a DWI scan, before and after they receive treatment for GBM. Researchers will compare the information from the scans with the results of treatment.

The hope is that the DWI scan will show quickly whether the tumour has stopped growing in response to treatment. It will also give doctors information about certain substances in the tumour, known as biomarkers, that indicate early on the chances of treatment success.

DWI shows promise, but it’s only been tested in single centres so far. DWI must be tested in several different settings before it can be used as a widespread, reliable measure of tumour response.

Why is it important?

Once treatment of an aggressive high grade GBM begins, it is vital to be able to tell if the tumour is responding or if it’s continuing to grow. Unfortunately, the standard MRI scanning used today is not good at doing this and better scanning methods are urgently needed. 

The researchers hope that with the additional information provided by DWI, doctors will be able to decide quickly whether to continue or adjust treatments, potentially saving lives and avoiding unnecessary drug side-effects.

Who will it help?

Most people with GBM require treatment with drugs after surgery. By providing more information about tumour response, DWI will help doctors pick the best treatments for these people. It will help avoid unnecessary drugs and improve the results of treatment.

It’s hoped that in future, this new type of scan will be used to help choose treatments for many other tumour types, including rare but devastating childhood tumours.

When the study is complete, we hope that the knowledge gained will be useful for treatment decisions for patients with GBM undergoing radiotherapy and chemotherapy after surgery.

Professor Adam Waldman