Brain Mass
Conditions
Keywords
mass in posterior fossa, benign, malignant, surgical resection, MRI, fMRI, DTI, 12-121
Brief summary
The purpose of this study is to better understand why some children with cancer have difficulty speaking after brain surgery. Difficulty speaking may be due to known complications to the language centers in the brain. These language centers may be located in slightly different places in different people. This study will study which areas may be damaged.
Interventions
PROCEDUREMRI with DTI and fMRI
When possible, the subject will undergo a post operative fMRI/ DTI scan as well as clinical language testing. If the subject develops CMS, the second fMRI will be performed as soon as possible. Some subjects may be severely impaired or have difficulty performing fMRI and clinical language testing tasks. In these instances, the fMRI and language testing may not be performed, or we may choose to perform resting state or passive fMRI tasks instead.
Sponsors
Memorial Sloan Kettering Cancer Center
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
3 Years to 21 Years
Healthy volunteers
No
Inclusion criteria
* Subject and/or guardian is able to provide written informed consent prior to study registration * Age ≥3 years and ≤21 years * Newly diagnosed, untreated mass in posterior fossa, either benign or malignant * Is being evaluated for surgical resection of the mass * Able to perform clinical language testing in English
Exclusion criteria
* Claustrophobia * Any contraindication to MRI (e.g., pacemaker, aneurysm clip, tissue expander). * Pregnant or nursing female * Does not speak English as a primary language (as determined by the P.I. or treating physician after discussion with a potential subject and his/her family) * Preexisting language or developmental disorder that would limit ability to cooperate with testing (as determined by the P.I. or treating physician after interviewing potential subject and his/her family; for example, a child may be excluded if he/she has confirmed or suspected autism spectrum disorder, dysarthria, dyslexia, lisp, hypotonia, or other age inappropriate speech development)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| investigate the feasibility of performing preoperative fMRI | 1 year | in young children at risk for developing CMS after posterior fossa brain tumor resection. Age appropriate language functional MRI tasks targeting the cerebellar language centers will be performed in children before surgery and correlated with formal neuropsychological and language testing. The fMRI will be repeated after surgery. If ≥5 of the 7 subjects successfully complete ≥60% of the functional imaging tests, we will determine the pilot study to be successful and then pursue further study. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To investigate potential changes in Diffusion Tensor Imaging (DTI) and tractography | 1 year | in subjects who develop CMS after brain tumor resection. Injury to cerebro-cerebellar tracts such as the dentatothalamocortical tracts has been implicated in the development of CMS. We propose studying the proximity between important language white matter paths and the surgical intervention before surgery. DTI: Measurements of DTI parameters (e.g., fractional anisotropy, apparent diffusion coefficient) of cerebellar and cerebro-cerebellar white matter tracts on the preoperative scan |
| To investigate potential changes in DTI after posterior fossa surgery | 1 year | that may correlate with the development of CMS. We hypothesize that measurements of water diffusion by DTI and tractography will be altered in subjects who develop CMS, even without striking anatomical changes after surgery. DTI: Measurements of DTI parameters (e.g., fractional anisotropy, apparent diffusion coefficient) of cerebellar and cerebro-cerebellar white matter tracts on the postoperative scan. The preoperative and postoperative DTI results will be compared. |
Countries
United States
Outcome results
None listed