Target Volume Determination 2015

MRI • State-of-the art for detection, delineation, and characterization • Functional imaging, incl. – MR angiography – Perfusion – Flow

Image contrasts: T1-weighted

Image contrasts: T2-weighted

Bright:

Fat

Bright:

Brain

Gd-DTPA

Short T1: Fat

Long T2: Fat

Tumour

Hematoma (depending on age !) Contrast medium: Disturbance of blood-brain barrier Proteins

Hematoma (Methemoglobin) Fluid Most tumours

CSF

CSF

– Neurofunctional MRI (BOLD) – Diffusion imaging (DWI+DTI) – MR spectroscopy

Oedema

Dark:

Tumour

Dark:

Short T2:

Contrast medium Bone, Calcium Hematoma (Hämosiderine)

Long T1: Water

Bone, Calcium

Moving blood Air

Moving blood Air

Bone

Bone

Brain

Vessels

Image Contrasts: FLAIR

Image contrasts: Proton-weighted

Intracranial tumors

• Intraaxial

• Extraaxial

FL uid A ttenuated I nversion R ecovery

Grey matter

White matter

– Supratentorial » Meningioma » Pituitary adenoma » Bone tumors » Meningial metastases – Infratentorial

– Supratentorial » Glioma

Tumour

Bright: Fat Fluid

» Lymphoma » Metastases

Tumours

– Infratentorial » Glioma

Dark:

Blood flow Air Bone

» Medulloblastoma » Ependymoma » Hemangioblastoma

= T2 with dark fluid

» Schwannoma » Meningioma » Epidermoid » Chordoma

CSF

Oedema