Implantation of brain tumors with Cf-252. Use of computed tomography and magnetic resonance imaging to guide insertion and evaluate response

Magnetic resonance imaging (MR) was evaluated as a guide to planning and follow-up of Cf-252 neutron brachytherapy in 8 patients with malignant glioma of the cerebral hemispheres. A combination of sagittal, transverse, and coronal views allowed three-dimensional assessment of the dimensions and extent of tumor; by comparison, CT scans delineated the tumor less sharply, multiple views were not routinely obtained, and the reconstructed sagittal images were inadequate. Both techniques were complementary in enabling accurate tumor localization as well as separating enhanced zones from central avascular regions and tumor from edema. However, MR images provided more detail than serial CT scans, making MR the preferred method of follow-up.