4A. Improving imaging techniques for childhood craniopharyngioma to better predict hypothalamic outcome.

Craniopharyngiomas are rare low grade brain tumours that grow in the hypothalamic-pituitary region. Of all craniopharyngiomas,  30-50% have a childhood onset. Treatment for craniopharyngioma is done by neurosurgery and radiotherapy. The overall survival rate is high (5-year survival: 83%-96%). Morbidity after treatment, however, is often devastating due to damage to the hypothalamus and its connecting structures. Hypothalamic dysfunction leads to morbid obesity, panhypopituitarism, temperature dysregulation, sleep problems and severe behavioural problems requiring 24/7 surveillance and care. More than half of the patients experience impairments in quality of life, neuropsychological function, and/or behaviour.

There are great differences in hypothalamic outcome between patients, which is poorly understood, and can insufficiently be predicted, but is very relevant for treatment. Conventional MRI focusses on imaging anatomy and is insufficient to visualize the specific hypothalamic nuclei. As metabolic changes often precede anatomical alterations and more directly reflect function, metabolic imaging would enable early detection and prediction of hypothalamic dysfunction.

For this specific project, we intend to use multi-nuclear metabolic imaging in children with craniopharyngioma, both newly diagnosed and during follow-up, to image the hypothalamus, the limbic system and the frontal cortex. We will use a newly developed multinuclear MR head coil at 7T MRI. With this unique RF coil, we can integrate 1H, 31P and 23NA imaging in one single scan session and proof feasibility of metabolic imaging in craniopharyngioma patients. Outcomes will be related to the degree of clinical hypothalamic dysfunction ( body mass index, temperature dysregulation, presence of pituitary deficiency, diabetes insipidus, thirst regulation, behaviour).

Necessary skills for this position:

• Medical degree or relevant biomedical Master’s degree
• Sufficient knowledge of Dutch language or willingness to learn Dutch