"If you're stuck, it helps to discuss your problem with people from different fields"

Patients with a brain tumor have an MRI  scan every three to six months for treatment follow-up. But doctors cannot always tell from the images whether the tumor has responded to treatment in that period. Bárbara Schmitz Abecassis (LUMC), PhD student at the scientific program Medical Delta Cancer Diagnostics 3.0: Big Data Science of in & ex vivo Imaging, investigates how ultra-high field MRI can provide  more imaging details of the tumor, and how those scans could provide a more accurate assessment of treatment response.

This interview is the first in a series of interviews with PhD students and PostDoc researchers funded by Medical Delta. Bárbara's PhD research is funded by the Medical Delta Cancer Diagnostics 3.0: Big Data Science of in & ex vivo Imaging scientific program.

What does your project look like?

"My project is part of a scientific program that is investigating the latest imaging techniques, with the goal of making a better and faster diagnosis of cancer. I am conducting a pilot study on an MRI scanner that has a higher resolution than the scanners currently used in hospitals. I have now scanned 25 patients with a brain tumor and am starting to analyse the data. The goal is to investigate what information we can get from the higher resolution scans, with the aim of better monitoring these patients’ treatment response."

What findings do you have so far?

"In a number of cases, we are already seeing that the higher resolution scans are providing new information. For example, we have an indication that the tumor extent can be better outlined on the high field MRI scans. In the future we would like to investigate how these scans could help us to depict tumor growth earlier. Ultimately, I hope we can contribute to the clinical workflow with these high-resolution scans. If doctors  are in  doubt about whether a tumor is recurring, a more detailed  scan can help them make a better informed decision about the right treatment.

But we are not there yet. We do now have the technology to get more imaging information about these  tumors, but that does not immediately mean a doctor can already apply that information in the clinic. I am therefore also investigating another MRI technique that can provide information on the tumor metabolism.

I have received help from all sides to better decide which information was clinically useful and technically feasible to record.In addition, we would also like to extend this pilot project. For example, we now only make one scan per patient. In a follow-up study, we would like to follow patients over a longer period of time, with multiple high-resolution scans. This would give us an even better idea of how a tumor develops in response to treatment."

What is an important lesson you have learned?

"There is usually a lot that goes differently than expected. What I learnt is that if you get stuck, it helps to discuss your problem with people from different fields. For example, patients can only lie still in the MRI scanner for approximately one hour, therefore given the limited time I had to make well informed decisions based on my goals to choose which type of MRI-scans I would like to acquire in that hour. I discussed this with both radiologists as well as neurooncologists, because they are focused on the patient care, clinical application, and interpretation of the data. The technical feasibility, on the other hand, is something I have discussed with engineers of the Gorter Center in the LUMC. I have received help from all sides to better decide which information was clinically useful and technically feasible to record."

What tips do you have for students and new scientists involved in Medical Delta?

"I personally enjoy working with people from various disciplines. We look at the same challenge from different angles. This is crucial if you want to solve a complex problem. It is important to be flexible and to be able to adapt to different situations. But it is also important to be confident  of yourself. People from different fields look at a  research question from different perspectives and fortunately, I have many helpful colleagues around me from different fields of expertise, with whom I can discuss my project. In the end, the most important aspect when navigating different research possibilities is to stand with what you believe in and what motivates you."