Primary tumors of the central nervous system (CNS) are the most frequent solid tumors in childhood and adolescence. In Germany, about 400 patients are newly diagnosed with a CNS tumor each year. Thanks to continuously optimized diagnostics, supportive care regimens, and multicentric, multimodal treatment concepts, their overall survival (OS) has increased from below 50 % up to 70 % over the last decades. Both tumor and treatment, and still developing CNS structures, make survivors prone to a risk of acquiring brain function deficits that are much higher than in adulthood or other childhood cancer survivors. Hence, this specifically vulnerable group of childhood cancer survivors must deal with chronic health conditions that may have serious impact on their physical, mental, emotional, and psychosocial development as well as their activity and participation as members of the society.
Due to the heterogeneity of pediatric brain tumors and corresponding treatment concepts, not all survivors share the same risk of developing such sequelae. Neuroimaging in surveillance plays a critical role in differentiating underlying neuroanatomical processes that are responsible for the brain function deficits observed. It helps improving current treatment strategies and interventional concepts for management of late effects as well as identifying risk factors.
Based on the international literature, the following chapter reviews and discusses the current understanding, options, and limitations of pediatric neuroimaging regarding common tumor- and treatment-related late effects in pediatric brain tumor survivors.
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