Our research aims to understand the characteristics of individual brain tumours, combining cutting edge brain imaging, molecular neuropathology and neurosurgical techniques to develop personalized approaches for first-line cancer surgery.
We are a multidisciplinary team of research and clinician scientists. Our research focuses on diffuse gliomas, which are the most common primary brain tumour in adults. Some 5000 people die from brain tumours each year, according to statistics from the Brain Tumour Charity. Gliomas are incurable and, at the moment, there are no targeted disease-modifying therapies. Surgery therefore remains the first-line treatment. Our studies are directly aimed at improving neurosurgical decision making, by helping to select which patients are most likely to benefit from surgery, when is the right time to operate, what is the surgical target zone to maximise long-term survival, and where are the absolute surgical margins that must be respected to minimize the risk of disability.
We take a closely integrated multidisciplinary approach, combining developments in modern molecular techniques, non-invasive neuroimaging and surgical approaches to understand brain tumour processes unique to individual patients. Our research aims are to:
- Understand the molecular and metabolic signatures of tumours and how they grow
- Identify the transition zone between low grade gliomas and surrounding normal brain
- Understand how brain tumours interact with and affect surrounding functional networks
- Determine the ideal and maximal resection zone through functional networks
- Understand how surgical morbidity and hospital length of stay can be reduced using a minimally invasive endoscopic approach to resect brain tumours
- Imaging: Magnetic Resonance Spectroscopy: We are developing 3T and ultra-high field (7T) and whole-brain techniques to measure the chemical characteristics and the spatial extent of tumour processes, to help us understand tumour growth and transformation.
- Imaging: Functional and Diffusion MRI: We are testing whether specialised MRI brain imaging techniques that measure brain activity and connectivity can accurately predict the risks of surgery to important skills such as language and memory.
- Tissue Metabolomics: We have developed new methods to analyse chemicals (metabolites) in tumour cell lines and tissue biopsies, in collaboration with the University Department of Chemistry. These new approaches are helping us to identify unique tumour signatures that may help us better classify tumours, predict patient prognosis, understand treatment resistance, and ultimately, tailor treatment.
- Raman Spectroscopy: we are investigating whether Raman spectroscopy can provide rapid real-time, accurate intraoperative identification of tumour boundaries for maximal tumour resection.
- Endoscopic minimally invasive brain tumour surgery: We perform endoscopic minimally invasive surgery to remove brain tumours. This minimises tissue damage when surgically accessing deep-seated tumours using computer-guided endoscope cameras. We are also developing new techniques locally in collaboration with Prof Zhong You at the University Department of Engineering.
You can contribute to our research via the Oxford Brain Tumour Research Fund.
- Published paper: May 2016. "Improved localisation for 2-hydroxyglutarate detection at 3T using long-TE semi-LASER". Berrington et al., in the journal Tomography (in press).
- Anatomy and Dissection Course: Mar 2016. Our UK's first Subcortical 3D anatomy and white fibre dissection course, which ran from March 21-23 proved hugely popular. We will be organising new courses soon, please do check back or contact Mr Plaha for details on upcoming dates.
- New student joins the group: Nov 2015. Congratulations to Annie Sokolich who has joined Natalie’s FMRIB research group to undertake a 3-year DPhil under joint supervision with Mark Stokes
- Published conference paper: Oct 2015. Our new 3T detection of 2-HG in tumour patients is published in Magnetic Resonance Materials in Physics, Biology and Medicine (Oct 2015, Vol 28, Suppl 1, abstract 392) “Improved detection of 2-hydroxyglutarate with a broadband semi-LASER sequence at 3T”
- Published paper: Cancer Research: Oct 2015. “Non-invasive quantification of 2-hydroxyglutarate in human gliomas harbouring IDH1 and IDH2 mutations” Emir et al. 2015 in the journal Cancer Research.
- New student joins the group: Sept 2015. Congratulations to James Livermore, who was recently awarded funding to undertake a 3-year DPhil with Puneet Plaha and Olaf Ansorge
Awake Neurosurgery video: Mr Plaha provides a step-by-step description of awake neurosurgery to the BBC (warning: surgical content). Video kindly provided by BBC Wiltshire on their Facebook site: https://www.facebook.com/BBCWiltshire/videos/632578940244900/
Oxford Brain Tumour Open Day: This joint NDCN/Oxford Cancer Research Centre one-day event in November 2015 involved tours of our research and clinical facilities with presentations by Olaf, Puneet, Uzay and Natalie. Over 50 people attended the event and 100% of respondents felt that the event had improved their understanding about brain tumours and what is being done to improve diagnosis and care in Oxford. Read more...
Surgical course on fibre dissection for surgeons: March 2016. Our UK's first subcortical 3D anatomy and white matter fibre dissection course for consultant neurosurgeons ran from March 21-23 with generous support from, and in partnership with, Medtronic. Please check back soon, or contact the course director Mr Puneet Plaha for details on dates for the next course in 2017.
Funding award: August 2013. We are extremely grateful for a generous donation from the HDH Wills 1965 Charitable Trust to help us undertake research into advanced brain imaging for tumour surgery.