SEQUENTIAL BRAIN SCANNING IN RADIATION THERAPY OF MALIGNANT TUMORS OF THE BRAIN

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Abstract
The isotope encephalogram obtained before surgery and radiation therapy from patients with primary or metastatic tumors of the brain furnishes valuable diagnostic criteria to the clinician. The pretreatment brain scan may contribute data of diagnostic value, but its authentic usefulness in treatment planning surpasses other diagnostic media by virtue of indicating the site and volume of the brain lesion to be irradiated. A high index of reliability of the followup brain scans in 21 irradiated patients in predicting new sites of growth was evident. During the clinical remission, the areas of increased uptake reverted to "normal" or appeared markedly "improved" as compared with the pretreatment scans. The follow-up scans gave the impression of being unaltered for a time in 2 patients who did not respond to treatment, and were definitely worse in a single case with no clinical improvement during therapy. The detection of recurrences after clinical remission invariably parallels the worsening of the image and pattern of thee areas of uptake from a month to years post treatment. Irradiation of the brain dose not result in change detectable on brain scans of the surrounding structures in the absence of tumor activity. The serial scanning using technetium 99 m can be performed with equanimity, and the morbidity is nil. The procedure is useful, and cumulative material conceivably will confirm that it is well indicated in radiation therapy of neoplastic processes of the brain.

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