Abstract
Radiotherapy either alone or in combination with temozolomide is a key element for the treatment of high-grade brain tumors at primary diagnosis and even at recurrence of disease (Stupp et al., 2009; Niyazi et al., 2011b). Nevertheless the clinical course of primary malignant brain tumors remains dismal, since early local failure is common. At least in part local failure is related to a diffuse tumor growth and difficulties in visualizing the relevant borders of the tumor contaminated area. Advances in radiation therapy technique such as 3D-conformal radiation, stereotactic radiotherapy (Combs et al., 2005), and intensity modulated radiotherapy (IMRT; Veldeman et al., 2008; Jin et al., 2011) as well as improved image-guidance radiotherapy (IGRT; Minniti et al., 2010; Wilbert et al., 2010) provide the ability to deliver radiation dose with increasing precision. In order to take full advantage of these technological advances there is a need for precise tumor delineation and target definition. This subsequently demands for precise imaging. Besides conventional radiotherapy planning being still based on computed tomography (CT) due to dose calculation algorithms additional magnetic resonance imaging (MRI) has become current standard-of-care with a high soft tissue contrast (for planning purposes and during follow-up Gladwish et al., 2011). Current and future research in this field are focused on the meaning of special or new sequence techniques (Laprie, 2009; Stall et al., 2010). Positron emission tomography (PET) has become a further option in recent years (Grosu et al., 2005a).
Highlights
Radiotherapy either alone or in combination with temozolomide is a key element for the treatment of high-grade brain tumors at primary diagnosis and even at recurrence of disease (Stupp et al, 2009; Niyazi et al, 2011b)
Besides conventional radiotherapy planning being still based on computed tomography (CT) due to dose calculation algorithms additional magnetic resonance imaging (MRI) has become current standard-of-care with a high soft tissue contrast
Available data suggest that different amino acid tracers have comparable imaging characteristics in brain tumors (Becherer et al, 2003)
Summary
Radiotherapy either alone or in combination with temozolomide is a key element for the treatment of high-grade brain tumors at primary diagnosis and even at recurrence of disease (Stupp et al, 2009; Niyazi et al, 2011b). Available data suggest that different amino acid tracers have comparable imaging characteristics in brain tumors (Becherer et al, 2003). Target Volume Delineation The use of molecular imaging in treatment planning of brain tumor patients is focused on tumor volume delineation.
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