Advances in brain tumor imaging and therapy

Abstract

This issue of the Neuroimaging Clinics of North America is truly a joint effort by radiologists and clinical scientists who are at the forefront of brain tumor imaging and therapy. The topic of brain tumor assessment was chosen because it is anticipated that imaging techniques will be required to change substantially in the next decade. This change is needed to keep pace with the rapid advances being made in brain tumor therapy. Therefore, radiologists need to be aware of the major forms of new therapies, which, while still in the research mode at the time of publication, may soon have mainstream clinical applications. Two fundamental assumptions determined the selection of topics for this issue. First, if radiologists become aware of therapeutic advances, it will become apparent that conventional imaging techniques are frequently unable to provide answers to questions posed by colleagues who treat brain tumor patients. The days when one could simply provide measurements of tumor size are near their end. Increasingly, neuro-oncologists and other treating physicians want to know physiologic responses to agents before changes in tumor size are apparent. The second assumption is that the remarkable advances made in imaging assessment of tumors in the past decade would be a source of encouragement for treating physicians. Perhaps this issue of the Neuroimaging Clinics of North America will invigorate treating physicians to more fully involve radiologists in the planning of their research and therapy so that imaging and therapy of brain tumors can be more closely linked. Whenever possible, articles have been designed in couplets, with an article on imaging aspects of brain tumor therapy and a companion article on the physiologic basis of that therapy. For instance, the article on imaging of viral therapies in treatment of brain tumors has a parallel article on the physiologic mechanisms that underlay the therapeutic use of viruses. Similarly, both an article on the role of hypoxia in brain tumor therapy and an article on imaging of tumor hypoxia are provided. One further example is the combination of an article on anti-angiogenesis therapy for brain tumors and one on the role of hemodynamic imaging of brain neoplasms. I wish to express my gratitude to the authors who contributed to this corpus and who graciously set aside other projects to make this issue a reality. They have succeeded in clearly presenting many complex issues and in providing the most recent information on imaging and therapy. Thanks must also be given to the authors of various articles who