Assessment of posterior fossa target definition by multimodality imaging for patients with medulloblastoma

Omer Sager*, Selcuk Demiral, Ferrat Dincoglan and Murat Beyzadeoglu

Objective: Medulloblastoma is a frequent childhood brain tumor which may occur in the vermis, cerebellum and posterior fossa. Affected patients may suffer from a variety of symptoms due to elevated intracranial pressure and may present with headaches, nausea and vomiting, cranial deficits, truncal ataxia, titubation of the head, alterations in mental status and gait disturbances. Accuracy in target and treatment volume definition has been thoroughly studied to achieve better outcomes. Herein, we assessed posterior fossa target definition by multimodality imaging patients with medulloblastoma.

Materials and methods: In this study, posterior fossa target definition with multimodality imaging by incorporation of Magnetic Resonance Imaging (MRI) or by Computed Tomography (CT)-simulation images only was evaluated comparatively for patients with medulloblastoma. Board certified radiation oncologists have outlined the ground truth target volume as the reference for actual treatment and for comparison purposes after thorough assessment, collaboration, colleague peer review, and ultimate consensus.

Results: RT planning was performed by use of the available treatment planning systems at our tertiary referral institution with prioritization of target coverage and normal tissue sparing to improve the therapeutic ratio. Decision making for individualized patient management was performed by multidisciplinary evaluation of experts from neurosurgery, radiology, pediatric oncology, medical oncology, and radiation oncology. Synergy (Elekta, UK) LINAC was used for RT administration. Ground truth target volume was found to be identical with target volume definition with CT-MR fusion based imaging as the result of this study. 

Conclusion: Multimodality imaging should be strongly considered for improved posterior fossa RT target definition of medulloblastoma. Apparently, further studies may be needed to shed light on this issue.

Keywords:

Published on: Mar 19, 2021 Pages: 37-41

Full Text PDF Full Text HTML DOI: 10.17352/2455-2968.000133
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