Magnetic Resonance Imaging and Magnetic Resonance Spectroscopic Imaging in Evaluating Patients Who Are Undergoing Treatment for Gliomas

Magnetic Resonance Imaging and Magnetic Resonance Spectroscopic Imaging in Evaluating Patients Who Are Undergoing Treatment for Gliomas

RATIONALE: Diagnostic procedures, such as magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI), (done before, during, and after treatment) may help doctors predict a patient's response to treatment and help plan the best treatment. PURPOSE: This phase II trial is studying how well MRI and MRSI evaluate patients who are undergoing treatment for gliomas.

OBJECTIVES: Determine the magnetic resonance spectroscopic imaging (MRSI) characteristics of patients who are undergoing treatment for supratentorial glioma. Determine the survival of patients who undergo magnetic resonance imaging and MRSI. Determine the clinical outcome of patients who undergo these imaging procedures. Correlate measures of metabolic tumor burden (i.e., CNI, CCCrI, CrNI, and LLI) with survival and clinical outcome in patients who undergo these imaging procedures. Determine the time to clinical progression in patients who undergo these imaging procedures. OUTLINE: Patients are assigned to 1 of 2 treatment groups based on grade of disease. Group 1 (patients with grade II glioma): Patients undergo magnetic resonance imaging (MRI) and magnetic resonance spectroscopic imaging (MRSI). Patients then receive chemotherapy. Patients undergo repeat MRI/MRSI after courses 2 and 4 of chemotherapy. Group 2 (patients with grade III-IV glioma): Patients undergo MRI/MRSI and then undergo surgical resection of the tumor. Patients then receive chemoradiotherapy. Patients undergo repeat MRI/MRSI within 2 weeks and at 2 months after completion of radiotherapy. Patients are followed for recurrence, disease progression, and survival. PROJECTED ACCRUAL: A total of 250 patients will be accrued for this study.

adult anaplastic astrocytoma, adult diffuse astrocytoma, adult glioblastoma, adult giant cell glioblastoma, adult gliosarcoma, adult pilocytic astrocytoma, adult anaplastic ependymoma, adult ependymoma, adult myxopapillary ependymoma, adult subependymoma, adult anaplastic oligodendroglioma, adult oligodendroglioma, adult mixed glioma

DISEASE CHARACTERISTICS: Histologically confirmed supratentorial glioma Grade II-IV disease Previously untreated disease Eligible for surgical resection and/or chemotherapy with or without radiotherapy Tumor accessible by magnetic resonance spectroscopic imaging PATIENT CHARACTERISTICS: Karnofsky performance status 60-100% Life expectancy ≥ 8 weeks Not pregnant No contraindication for magnetic resonance examinations, including any of the following: Cardiac pacemaker or fibrillator Aneurysm clip Insulin or infusion pump Any implant held in place by a magnet Metal contamination anywhere in the body PRIOR CONCURRENT THERAPY: No prior chemotherapy No prior radiotherapy No prior treatment for the malignancy