Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi
Part 4 of 9 in Diagnosis and Management of Brain Tumour
Diagnosing Brain Tumours: CT, MRI and Beyond
June 9, 2024
Diagnosing a brain tumour relies on imaging rather than blood tests, and imaging can also predict, with reasonable accuracy, whether a tumour is likely to be benign or malignant before biopsy confirms it.
Imaging modalities
CT scan and MRI are the primary diagnostic tools; MR spectroscopy, PET scan and SPECT scan can help further characterise a tumour. Blood tests are usually not helpful for diagnosis without accompanying imaging.
Predicting benign versus malignant before biopsy
A CT scan and MRI together can predict, with about 90% accuracy, whether a tumour is benign or malignant. However, only a biopsy provides definitive confirmation of both the diagnosis and the tumour's grade.
This article is based on a Jivo Masterclass session conducted by Dr. Sonal Gupta, Principal Director & HOD, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
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This guide is based on a live Jivo Masterclass: Dr. Sonal Gupta taught doctors across Africa on June 9, 2024.
FROM THE LIVE Q&A
Moderator
How are childhood brain tumours identified and managed differently from adult ones?
Dr. Sonal Gupta
Identification is the same as in adults. The surgical approach is also the same, but radiotherapy and chemotherapy protocols must be modified according to the child's age.
Frequently Asked Questions
Can a brain tumour be detected in a newborn?▼
Yes. An ultrasound of the skull can be used as a screening test to check for excess fluid or a tumour, but an MRI is required for a definitive diagnosis even in a newborn.
What are the post-operative complications of brain tumour surgery?▼
Complications have come down to under 5% of cases. They include epilepsy, a haematoma (clot) at the surgical site, infection from open surgery, and, if the tumour is very large, the possibility that a portion has to be left behind.
Will children benefit from epilepsy surgery at an early age?▼
Yes. If a child is dependent on multiple anti-epileptic medications, surgery helps by reducing both the number of medications needed and their side effects.
A 19-year-old has been on epilepsy follow-up and medication for 10 years. The MRI is negative, but the EEG shows a slow-wave background. What is the next step?▼
This patient should be referred for a dedicated epilepsy workup.
After a complete resection of a cancerous mass, there is a void left in the brain. How does this void evolve during healing, and are there always neurological sequelae?▼
A cancer tumour can never be removed completely; microscopic cells are always left behind. Because these tumours cause significant surrounding brain swelling, the surgical cavity fills in quickly on its own, so the void itself is not a concern.
How is a brain tumour diagnosed?▼
Primarily through CT scan and MRI, with MR spectroscopy, PET and SPECT scans used for further characterisation. Blood tests alone are not diagnostic.
Can imaging tell if a tumour is benign or malignant?▼
CT and MRI together can predict this with about 90% accuracy, but only a biopsy gives a definitive diagnosis and grade.
In This Series: Diagnosis and Management of Brain Tumour
- 1.Brain Tumour
- 2.How Brain Tumours Are Classified: Benign, Malignant, Primary and Secondary
- 3.Brain Tumour Symptoms and Which Headaches Are Red Flags
- 4.Diagnosing Brain Tumours: CT, MRI and Beyond
- 5.Brain Tumour Surgery and Radiosurgery: Treatment Options Explained
- 6.Brain Tumour Surgery: Realistic Complication Rates and Recovery
- 7.Epilepsy Surgery: Who Needs It and How It Helps
- 8.Brain Tumours in Children and Newborns: Diagnosis and Management
- 9.Real Brain Tumour Cases: Weighing Surgery Against Radiosurgery