1. Anthony Chalmers welcomed the delegates and speakers and gave a brief overview of the history of the meeting and the main aims of the initiative. This meeting had a very specific aim to work towards the creation of a Scottish ‘Network of Excellence for imaging research in neuro-oncology’, which has been made possible by significant investment in brain tumour research in Scotland, particularly Edinburgh.
2. David Jenkinson of The Brain Tumour Charity gave an overview of developments at the Charity and outlined funding opportunities that the grouping could apply for. Anthony and the other delegates thanked David and the Charity for their generous sponsorship of the meeting.
3. To develop understanding of the resources available and the work being conducted across Scotland, overviews of teams, activities and facilities were provided for neuro-oncology research in Glasgow (by Anthony Chalmers) and Edinburgh (by Adam Waldman) and for imaging research in Aberdeen (by Alison Murray).
It was apparent that the resources and expertise available were highly complementary and provided excellent opportunities for collaborative projects in a number of specific fields including cancer metabolism and late effects of treatment. Some resources were also ideal for fostering broader national and international collaborations (e.g., 7T MRI in Glasgow, PET-MRI in Edinburgh, Fast Field Cycling MRI in Aberdeen).
Anthony cited Antoine Vallatos’ work using preclinical MRI to interrogate the invasive behaviour or glioblastoma as a prime example of how SANON-SINAPSE meetings have identified important research questions and supported the building of successful, collaborative research programmes. Having completed a 3-year post-doc position in Glasgow (funded by TBTC), Antoine has taken up a position as a Research Associate in Preclinical and Clinical Imaging in Edinburgh where he will be ideally positioned to continue collaborations across the centres, connecting preclinical and clinical research teams.
In the discussion that followed, our international keynote speaker Elizabeth Maher asked about possibility of patients moving between centres to participate in trials. Alison advised that there is capacity and precedents for this to occur in Scotland and supported the concept of a network of centres. Adam pointed out that Scotland has huge potential for collaborative studies because of the shared PACS systems across NHS health boards that allows efficient sharing of patient data.
4. Colin Smith of Edinburgh provided an entertaining and highly informative overview of the updated WHO classification of gliomas, which was felt to be crucial to designing and interpreting imaging studies.
5. This year’s international keynote speaker was Elizabeth Maher of UT Southwestern Medical Centre in Dallas. Elizabeth’s title was ‘Imaging 2HG: A window into the biology of IDH-mutant gliomas’ and her highly engaging and inspiring presentation covered the basic science and the exciting clinical potential of using PET imaging to study IDH1 and 2 mutations in a longitudinal fashion. Elizabeth also emphasised the absolute requirement for international collaboration in this field.
6. This was followed by David Lewis who has recently been appointed as a Junior Group Leader at the CRUK Beatson Institute in Glasgow. David presented some of the exciting developments in preclinical neuro-imaging and showed examples of how new techniques could be used to assess mutational status and metabolic heterogeneity in brain tumours.
7. After lunch, Antoine Vallatos, Sally Pimlott and Anthony Chalmers presented brief updates on the various projects that have arisen from previous SANON-SINAPSE meetings.
8. Next came a new concept for this year’s meeting: the SANON-SINAPSE pitches. Delegates had been invited to propose new, relatively undeveloped ideas for future projects and two had been selected for presentation at the meeting.
First, Antoine Vallatos pitched the concept of ‘Perfusion as a marker of low brain tumour infiltration’. There was a great deal of interest, with delegates asking about interrogation of the margin outside regions of T2 abnormality, tumour cells migrating in response to treatment and the need to validate non-invasive markers of invasion. It was agreed that preclinical studies incorporating detailed histology could be used to inform clinical studies that could validate key concepts.
Next, Emanuela Molinari pitched: ‘Depression and quality of life in brain tumours: New applications for MRI?’ Again, there was significant interest but the complexity of the patients and the imaging was acknowledged. Delegates discussed ongoing and future studies upon which imaging investigations could be based and identified potential collaborators in Scotland and beyond.
There was a clear commitment to developing both project ideas further, and project teams have been created.
9. To conclude the meeting Anthony asked delegates for their views on the feasibility, value and potential structure of a Scottish ‘Network of Excellence’ for imaging research in neuro-oncology.
There was strong support and potential key scientific themes and technological points of focus were identified. As Director of SINAPSE, Alison Murray offered administrative and some financial support for this meeting and it was agreed that a web presence hosted by SINAPSE would also be greatly beneficial. It was agreed that something more substantial than the annual meeting would be required to make a real impact.
Adam Waldman expressed strong support and suggested identifying and developing a few core projects to highlight benefits and justify further investment. Core infrastructure funding would be hugely beneficial but unlikely to be secured until individual projects had been funded and shown promise.
Gerry Thompson suggested an over-arching title of ‘Precision Glioma’ for which he has already secured social media and internet rights. All agreed this would be an ideal title and would be an excellent brand incorporating imaging, metabolism, molecular markers and personalisation of imaging and treatment. Engagement with neurosurgeons and neuropathologists would be crucial to enable targeted biopsies that could be correlated with imaging.
10. The final discussion illustrated a clear commitment to making the SANON-SINAPSE network more substantial and better supported to be more productive. It is imperative that this process continues beyond the annual meeting.
[Many thanks to Irene Clark for preparing the meeting notes; she can be contacted regarding access to presenter slides: firstname.lastname@example.org]