TheraGlio aims at developing combined imaging technologies for diagnostic and tailored therapeutic interventions for patients bearing MGs. This will be carried out by creating a novel multimodal imaging system, which will employ new generation MBs that can simultaneously act as contrast agent for Magnetic Resonance Imaging (MRI), intra-operative Contrast-Enhanced US Imaging (CEUS) and intra-operative fluorescence-guided microscopic resection of MG. Moreover,newly generated MBs will be loaded with specific targeting molecules and chemotherapeutics for localized release. The specific objectives of the project will be: 1) Designing a new neurosurgical navigation system to simultaneously acquire intra- operative US and operative-microscope images, and match them with the pre-operative MRI scans in real-time. 2) Manufacturing and preclinical assessment of stability, toxicity and efficacy of lab-scale and clinical-grade GMP certified multimodal lipidic MBs as an intra-operative neuronavigation tool. 3) Manufacturing and physical characterization of polymeric (bio-inert or biodegradable),multifunctional MBs, which will be functionalized for MRI, US and fluorescence microscopic visualization. 4) Development of multifunctional drug-loaded-nanoparticle equipped biodegradable MBs as drug delivery platform. 5) Clinical assessment of feasibility, toxicity, and efficacy of multimodal modified lipidstabilized MBs for real-time MR/US image/fluorescence guided surgery using an integrated neuronavigation platform in recurrent GBMs.
MedCom will be involved in the first objective. The aim is to design and develop an advanced image-guided neurosurgical navigation platform based on pre-acquired contrast-enhanced MRI images, which can be constantly and effectively updated through intraoperative CEUS imaging. Since CEUS and US-navigation are already approved in Europe for clinical use, we expect that within the duration of the project this novel real-time neuronavigation system will be eventually tested and validated in the clinical setting. The new software will be based on an innovative image fusion tool that correlates preoperative MR (and possibly other imaging modalities) and real-time US imaging in a 3D frame; this process will improve neuronavigation by correcting intrinsic registration errors, tissue distortion, as well as brain shift allowing the surgeon to perform a true real-time navigated neurosurgical operation. Eventually,combined navigated MR and intraoperative US images will be visible as superimposed images through the oculars of the operative microscope.
Official TheraGlio Homepage: www.theraglio.eu/project