title: Imaging changes in very young children with brain tumors treated with proton therapy and chemotherapy.
abstract: 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.
authors: Department of Radiological Sciences, St. Jude's Children's Research Hospital, Memphis, Tennessee 38105, USA. noah.sabin@stjude.org
authors: N D
authors: ND
authors: Sabin
authors: T E
authors: TE
authors: Merchant
authors: J H
authors: JH
authors: Harreld
authors: Z
authors: Z
authors: Patay
authors: P
authors: P
authors: Klimo
authors: I
authors: I
authors: Qaddoumi
authors: G T
authors: GT
authors: Armstrong
authors: K
authors: K
authors: Wright
authors: J
authors: J
authors: Gray
authors: D J
authors: DJ
authors: Indelicato
authors: A
authors: A
authors: Gajjar
mesh_terms: D001932:Brain Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D002277:Carcinoma / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D002528:Cerebellar Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods*; D002675:Child, Preschool; D016545:Choroid Plexus Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D038524:Diffusion Magnetic Resonance Imaging; D004806:Ependymoma / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005682:Gadolinium; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008527:Medulloblastoma / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D018242:Neuroectodermal Tumors, Primitive / Q000453:epidemiology / Q000473:pathology / Q000628:therapy; D061766:Proton Therapy / Q000009:adverse effects / Q000379:methods*; D011829:Radiation Dosage; D018335:Rhabdoid Tumor / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D012307:Risk Factors; D013724:Teratoma / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*
chemical_list: D005682:Gadolinium