Craniospinal irradiation (CSI) using IMRT allows dose sparing to organs-at-risk (OAR) whilst conforming the dose to the target volume. Due to the complexity of treatment involving several isocenters, the dose distribution created by the inverse-planned segmented fields must be verified prior to treatment. We propose and test methods to verify dose delivery using commonly available dosimetry equ...

OBJECTIVES To determine lumbar spine and total body bone mineral density (BMD) in pediatric patients who have undergone cranial or craniospinal irradiation for posterior fossa tumors, specifically medulloblastoma and ependymoma and to analyze the association between degree of osteopenia and factors that may affect BMD. METHODS Retrospective and prospective data collection included medical rec...

Head injury is a common form of trauma. For example, in the UK head injury occurs in more than 500 000 persons per annum of which about 10% are diagnosed as severe, 15% moderate and the remainder as minor head injury (Miller et al., 1992; Pickard and Czosnyka, 1993). Head trauma is a significant cause of death and disability, especially in young males (median age < 30) and is associated with ra...

PURPOSE To develop a new IMRT technique to simplify the process and improve efficiency in radiotherapy treatment planning for craniospinal irradiation (CSI) treatment. METHODS Image data of 9 patients who received CSI treatment in 2012 were used, the prescription was 36Gy in 20 fractions. Two treatment plans were created for each patient, one was with the new technique called three-isocenter ...

BACKGROUND Cranial reirradiation is clinically appropriate in some cases but cumulative radiation dose to critical normal structures remains a practical concern. The authors developed a simple technique in 3D conformal proton craniospinal irradiation (CSI) to block organs at risk (OAR) while minimizing underdosing of adjacent target brain tissue. METHODS Two clinical cases illustrate the use ...

We report a case of central neurocytoma that manifested tumor recurrence with craniospinal dissemination. Imaging studies before surgery showed a markedly enhanced tumor with small cysts and calcification, which invaded the adjacent brain parenchyma, located in the posterior horn of the right lateral ventricle. Proton MR spectroscopy showed markedly elevated choline and lactate peaks with a str...

Idiopathic hypertrophic pachymeningitis (IHP) is a rare disease, and it is characterized by chronic progressive inflammatory fibrosis and thickening of the dura mater with resultant compression of the spinal cord or neural structure without any identifiable cause. It can occur in the intracranial or spinal dura mater alone or as a craniospinal form. The spinal form is rarer than the cranial for...

Medulloblastoma, a malignant neoplasm of the posterior fossa with a high propensity for metastatic spread, is one of the most common central nervous system tumors in children. Despite the long-term survival of many patients, definitive therapy is associated with significant morbidity. Adjuvant craniospinal irradiation and chemotherapy leaves many survivors debilitated from treatment-associated ...