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
- FutureGB trial: We have been funded by the National Institute of Health Research (NIHR) with additional support from Brainlab and Medtronic to perform a prospective, multicentre randomised controlled trial in 357 patients over 27 months to find out whether additional imaging tools available in surgery make a positive difference to quality of life for people with fast-growing brain tumours who have surgery. You can read more about the trial here or in the paper protocol.
- Surgical approaches and techniques: We are actively evaluating the effects and benefits of surgery for patients, including survival prognosticators in elderly patients (Zorman et al 2022) and the role of early re-operation for residual enhancing disease (Ma et al 2018).
- 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. Recent publications: McKinnon et al 2020, Ma et al 2018a, Ma et al 2018b, Ma et al 2016.
- 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. Recent publications: Voets et al 2022, Voets et al 2021, Voets et al 2017.
- Imaging: Magnetic Resonance Spectroscopy: We have developed 3T, 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. Recent publications: Shen et al 2019, Berrington et al 2018, Steel et al 2018, Emir et al 2016.
- 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. Recent publications: Livermore et al 2020, Livermore et al. 2019
Our lead neurooncology neurosurgeon and colleagues are taking the 3-peaks challenge (climbing 3 peaks across the UK in 24 hours) this September (2022) to raise £100,000 for brain tumour research via the charity Brainstorm. If you'd like to contribute, please find the link to their justgiving page here.
- May 2023. Thank you to all our teams and industry partners for joining us for the FutureGB Surgical Symposium at Trinity College, Oxford on 12th of May for an excellent day of discussions and exchange of ideas!
- Jan 2020. Congratulations to James Livermore for passing his Phd thesis viva!
- Jun 2018. Anyone attending ISMRM might be interested in Natalie's lecture "Using tractography to guide brain tumour resections" in the special education seminar Tractography in the Operating Theatre.
- Aug 2017. Farewell to Uzay who will be sorely missed as he starts an exciting new tenure-track position in the USA.
- 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.
The FutureGB trial in Jun 2023 have recruited 179 participants, reaching 50% of the study target! Thank you to all our study teams, industry partners and most importantly, patients and their families!
A patient's perspective: Brain Tumour Research.org has published interviews with patients including those who have taken part in our research. You can read their story here.
2nd Oxford fibre dissection course: This year we again hosted 12 consultant neurosurgeons over March 27-28, 2017, coinciding with the Society for British Neurosurgeons conference this year in Oxford. Thanks to generous support from Brainlab and Severn and exceptional external speakers including Prof. Hugues Duffau and Dr Pablo Gonzalez, the course was a phenomenal success. Consultant neurosurgeons wishing to attend, please contact Mr Plaha for details on next year's course.
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.