Quality control of radiotherapeutic treatment of medulloblastoma in a multicentric study: The contribution of radiotherapy technique to tumour relapse

Carrié, C.; Alapetite, Claire; Méré, P.; Aimard, L.; Pons, A.; Kolodié, H; Seng, Sok-Hun; Lagrange, Jean‐Léon; Pontvert, D.; Pignon, T.; Lacroze, M.; Ginestet, C.; Bernard, J

doi:10.1016/0167-8140(92)90282-y

Cited by 92 publications

(44 citation statements)

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“…[1][2][3][4][5] These tumours arise infratentorially within the cerebellum or in the vicinity of the fourth ventricle. Their typical pattern of spread is to meningeal surfaces, frequently locoregionally in the posterior fossa.…”

Section: Clinical Settingmentioning

confidence: 99%

Fast imaging employing steady-state acquisition (FIESTA) MRI to investigate cerebrospinal fluid (CSF) within dural reflections of posterior fossa cranial nerves

Noble¹,

Scoffings²,

Ajithkumar³

et al. 2016

BJR

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Objective: There is no consensus approach to covering skull base meningeal reflections-and cerebrospinal fluid (CSF) therein-of the posterior fossa cranial nerves (CNs VII-XII) when planning radiotherapy (RT) for medulloblastoma and ependymoma. We sought to determine whether MRI and specifically fast imaging employing steady-state acquisition (FIESTA) sequences can answer this anatomical question and guide RT planning. Methods: 96 posterior fossa FIESTA sequences were reviewed. Following exclusions, measurements were made on the following scans for each foramen respectively (left, right); internal acoustic meatus (IAM) (86, 84), jugular foramen (JF) (83, 85) and hypoglossal canal (HC) (42,45). A protocol describes measurement procedure. Two observers measured distances for five cases and agreement was assessed. One observer measured all the remaining cases. Results: IAM and JF measurement interobserver variability was compared. Mean measurement difference between observers was 20.275 mm (standard deviation 0.557). IAM and JF measurements were normally distributed. Mean IAM distance was 12.2 mm [95% confidence interval (CI) 8.8-15.6]; JF was 7.3 mm (95% CI 4.0-10.6). The HC was difficult to visualize on many images and data followed a bimodal distribution. Conclusion: Dural reflections of posterior fossa CNs are well demonstrated by FIESTA MRI. Measuring CSF extension into these structures is feasible and robust; mean CSF extension into IAM and JF was measured. We plan further work to assess coverage of these structures with photon and proton RT plans. Advances in knowledge: We have described CSF extension beyond the internal table of the skull into the IAM, JF and HC. Oncologists planning RT for patients with medulloblastoma and ependymoma may use these data to guide contouring.

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Section: Clinical Settingmentioning

confidence: 99%

Fast imaging employing steady-state acquisition (FIESTA) MRI to investigate cerebrospinal fluid (CSF) within dural reflections of posterior fossa cranial nerves

Noble¹,

Scoffings²,

Ajithkumar³

et al. 2016

BJR

View full text Add to dashboard Cite

show abstract

“…In a material reported by the French medulloblastoma group, 2 out of 22 relapses (9"/) occurred in the mobile gap between the fields (6). The more reliable the field matching is, the narrower safety margin between the fields is required to avoid the threat of overdosing the spinal cord.…”

Section: Discussionmentioning

confidence: 99%

“…[6], the required matching geometry is achieved, if the measurement for A y is done correctly or with a slight error. Therefore, the presented method can 'correct' some possible errors of the field localization process.…”

Section: Discussionmentioning

confidence: 99%

“…Without any gap between the opposed fields and the posterior field, a longitudinal shift of 29.5 cm was calculated from Eq. [6]. beam from Philips SL75-4 was used.…”

Section: Half Of the Height Of The Posterior Fieldmentioning

confidence: 99%

“…Technical errors in the radiotherapeutic procedure have been shown to increase treatment failures of medulloblastoma (6). It has been'demonstrated that the incorrect field adjustment easily leads to remarkable dose inhomogeneity in the junctional region (3).…”

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confidence: 99%

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