TY - JOUR T1 - Imaging Changes in Very Young Children with Brain Tumors Treated with Proton Therapy and Chemotherapy JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. DO - 10.3174/ajnr.A3219 AU - N.D. Sabin AU - T.E. Merchant AU - J.H. Harreld AU - Z. Patay AU - P. Klimo, Jr AU - I. Qaddoumi AU - G.T. Armstrong AU - K. Wright AU - J. Gray AU - D.J. Indelicato AU - A. Gajjar Y1 - 2012/07/19 UR - http://www.ajnr.org/content/early/2012/07/19/ajnr.A3219.abstract N2 - 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/RTatypical teratoid rhabdoid tumorCGEcobalt gray equivalentCPCchoroid plexus carcinomaPNETprimitive neuroectodermal tumorPTproton therapy ER -