Improved localization of infratentorial ependymoma by magnetic resonance imaging: Implications for radiation treatment planning |
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Authors: | Brian R Griffin William P Shuman William Wisbeck Mitchell Berger Alexander Spence |
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Institution: | (1) Department of Radiation Oncology, University of Washington, Seattle, WA, USA;(2) Department of Radiology, University of Washington, Seattle, WA, USA;(3) Department of Neurological Surgery, University of Washington, Seattle, WA, USA;(4) Division of Neurology, Department of Medicine, University of Washington, Seattle, WA, USA |
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Abstract: | Ependymomas of the posterior fossa extend into the upper cervical spinal cord in approximately one-third of cases. Unfortunately,
the posterior fossa and upper cervical cord region is often poorly seen on computed tomography (CT), making radiotherapy planning
difficult. We report five cases of posterior fossa ependymoma with extension into the cervical cord where magnetic resonance
imaging (MRI) demonstrated the caudal extent of tumor more clearly than CT. The extent of tumor depicted by MRI in each case
correlated well with the operative findings. Higher doses of radiotherapy to the entire tumor volume are associated with improved
survival in infratentorial ependymoma; however, the radiation tolerance of the cervical spinal cord is close to the dose necessary
to control posterior fossa ependymoma, making limitation of radiation field volumes important. MRI may provide a method of
precisely defining caudal tumor extent of posterior fossa ependymomas so that limited volume, high dose radiotherapy can be
more safely administered to these patients. |
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Keywords: | ependymoma magnetic resonance radiotherapy treatment planning |
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