Abstract
SUMMARY: PT promises to reduce side effects in children with brain tumors by sparing normal tissue compared with 3D conformal or intensity-modulated radiation therapy. Information is lacking about the combined effects of PT and chemotherapy in young children. We describe imaging changes in 8 very young children with localized brain tumors who received PT after chemotherapy. Mostly transient signal abnormalities and enhancement in brain parenchyma were observed by serial MR imaging, which were consistent with radiation-induced effects on normal-appearing tissue. Correlation with PT planning data revealed that the areas of imaging abnormality were located within or adjacent to the volume that received the highest radiation dose. Radiologists should be aware of these findings in children who receive PT after chemotherapy. In this report, we describe the time course of these PT-related imaging findings and correlate them with treatment and clinical outcomes.
ABBREVIATIONS:
- AT/RT
- atypical teratoid rhabdoid tumor
- CGE
- cobalt gray equivalent
- CPC
- choroid plexus carcinoma
- PNET
- primitive neuroectodermal tumor
- PT
- proton therapy
- © 2013 by American Journal of Neuroradiology