CT and MR for brain tumor implant therapy using CF-252 neutrons.

Magnetic resonance (MR) imaging of the brain allows very effective localization of tumor in brain, visualization of brain reaction to tumor, peritumoral edema, as well as destruction of normal anatomy and spread of tumor. MR readily imaged the brain in multiple views allowing three dimensional (3D) evaluation and more precise localization of tumor in the depths of the brain. It also assessed the extent of tumor infiltration away from the primary site. In an ongoing study of Cf-252 neutron brachytherapy of hemispheric malignant gliomas of the brain, we have found that the extent of tumor and the planning of the placement of multiple applicators in the brain for implant therapy was facilitated by both CT and MR scanning, but MR allowed better 3D localization, assessment of response and follow-up of tumor response. MR gave additional and different types of information about the tumor than CT scanning based upon proton distribution which greatly aided planning of tumor implant therapy and understanding of patterns of tumor response and recurrence after therapy.