Imaging

Primary Brain Tumors

Preliminary Diagnosis: Primary Brain Tumors

I. What imaging technique is first-line for this diagnosis?

MR imaging of the brain with IV contrast

II. Describe the advantages and disadvantages of this technique for diagnosing primary brain tumors.

Advantages

  • Diagnostic with positive pertinent findings in the correct clinical situation.

  • Able to localize the area of abnormality better than any other modality.

  • Evaluates for secondary complications such as hemorrhage, mass effect, midline shift, etc.

  • Does not utilize ionizing radiation.

Disadvantages

  • Exposure to radiation.

  • Time consuming.

  • Requires significant patient cooperation to minimize motion artifact.

  • MR with contrast is contraindicated in patients with renal disease (i.e. GFR < 30).

III. What are the contraindications for the first-line imaging technique?

Contraindicated in patients with non-MR compatible metallic hardware or foreign bodies.

IV. What alternative imaging techniques are available?

  • FDG - PET

  • CT with contrast

V. Describe the advantages and disadvantages of the alternative techniques for diagnosing primary brain tumors.

FDG-PET

Advantages

  • Able to distinguish benign and malignant lesions based on degree of radiopharmaceutical uptake (i.e., a low grade glioma will demonstrate significantly less uptake than a high grade glioma).

  • Able to detect distant metastatic disease.

Disadvantages

  • Exposes the patient to a high degree of radiation.

  • Lacks the anatomic detailing of MRI and is unable to detect many secondary neurological complications.

  • Unable to fully characterize properties of neoplasm to the degree that MRI can.

CT with contrast

Advantages

  • Less expensive, quicker, and requires less patient cooperation than MRI.

  • Can determine many secondary complications, such as hemorrhage, mass effect, midline shift, etc.

  • Better than MRI at detecting calcified neoplasms.

Disadvantages

  • Lacks specificity and anatomic detailing of MRI.

  • Exposes patient to ionizing radiation.

VI. What are the contraindications for the alternative imaging techniques?

FDG-PET

  • Contraindicated in pregnant patients, especially during the first two trimesters.

CT with contrast

  • Contraindicated in pregnant patients, especially during the first two trimesters.

  • Relative contraindication in patients with renal failure.

  • Relative contraindication in patients with allergy to contrast.

You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs