DECISION-MAKING WITH Treatment Response Assessment Maps (tramS)

Elements TRAMs* is a novel MRI-based methodology for the high resolution depiction of contrast clearance and accumulation in brain tumor patients. 

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TRAMs Clinical Use

Clinical Use

Clinical studies affirm high positive predictive values (PPV) and outstanding sensitivity to active tumor. Elements TRAMs serve clinical specialties including Radiation Oncology, Neurosurgery, Neuro Oncology and Neuroradiology.

  • High resolution differentiation between contrast clearance and accumulation
  • Histological validation indicates strong PPV and sensitivity to active tumor tissues of most known brain tumor types
  • Supports ongoing assessment and clinical decision making before, during and after most treatments 
TRAMs Methodology


Elements TRAMs differentiate between contrast clearance and accumulation and support clinicians in separating tumor progression and treatment effects, such as radiation necrosis. Developed at Sheba Medical Center, Tel Aviv, with technology provided by Brainlab.

  • Two acquisitions of standard T1-weighted MRI—one 5 minutes and another 60-105 minutes after injection of a standard dose of contrast agent
  • First series is automatically subtracted from the second, resulting in the TRAMs
  • TRAMs are high resolution, volumetric maps separating regions of contrast clearance (blue) from contrast accumulation (red) more than one hour post contrast injection
  • Tumor tissues present efficient contrast clearance due to their viable vessels thus are depicted in blue, while non-tumor tissue with less efficient clearance are depicted in red


Work in progress