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Often the first diagnostic step is a neurological examination. A complete neurological examination checks eye movement and vision, hearing, sensation, reflexes, balance and coordination, motor skills, thinking and memory. After the neurological exam, the doctor may order imaging studies and lab tests to confirm the existence of a tumor and to gather more information about the type of tumor and its location. In addition, diagnostic tests are often used after treatment to monitor the outcome and recurrence of tumors. These diagnostic tests may include one or more of the following:
CT Scan (Computerized Tomography)
A CT scan directs x-rays from multiple angles to a specific body part. This creates detailed images of various cross-sections of tissues and bony structures, which can help identify the tumor’s location and can sometimes help determine the tumor’s type. CT scans can also detect swelling, bleeding, or other conditions associated with the tumor. Often CT scans are combined with a radiographic contrast media (dye) that is injected prior to the scan. The contrast dye highlights light and dark areas of the scan and makes it easier to identify abnormalities. This is known as a CT scan with myelogram. MRI
Magnetic Resonance Imaging (MRI) combines computer technology, a magnetic field, and radio waves to produce a two-dimensional image of a "slice" of the patient’s anatomy. This process is radiation free, and the radio waves are harmless. MRI scans produce highly detailed images from different angles and often make it easier to identify abnormal tissue, especially when tumors are located near bone. Sometimes a contrast dye is used, as in a CT scan with myelogram.
Positron Emission Tomography (PET) scans create color-coded pictures of brain activity by measuring levels of a low-dose radioactive sugar substance injected prior to the scan. The PET scan measures the consumption rate of the sugar substance in different parts of the brain. This is helpful in detecting recurrent tumor growth, and may help distinguish the grade of malignancy in an existing tumor.
Plain x-ray films of the skull may be used to determine the condition of the skull and the effect of the tumor on bony structures.
, also known as nuclear imaging, are used to detect areas of unusual activity in the bones using low levels of radioactive elements. Bone scans are highly sensitive and can reveal abnormalities that are too small to appear on other imaging tests. Bone scans involve the use of an injection and a scanner that produces images showing abnormal bone activity in darker shades.
A lumbar puncture, or spinal tap, may be used to obtain a sample of cerebrospinal fluid to look for substances that indicate the presence of a tumor.
Evoked Potentials Studies
Evoked potential testing involves stimulating the nerves using an electrical impulse. The transmission of that impulse along the spinal cord to the brain is then monitored via electrodes on the scalp.
Samples of blood and urine may be taken during the diagnostic process to measure hormone levels. This can help in diagnosing pituitary tumors.
An electroencephalogram (EEG) is a test that measures the electrical activity of the brain and looks for abnormalities. Electrodes detect patterns of electrical activity in the brain waves (electrical impulses between brain cells).
Brain Tumor Biopsy
After preliminary diagnostic tests are done, the exact diagnosis for a brain tumor is usually obtained through a biopsy, a surgical procedure in which the surgeon gathers a sample of the tumor. The tumor tissue and cells are then examined under a microscope.
The procedure used to obtain the tumor specimen (sample) depends on many factors including the tumor location and the patient’s health. Biopsies can be performed two ways. A needle biopsy can be performed through a small hole drilled in the skill. Often surgical image guidance systems are used to guide the needle to the tumor. Tumor specimens can also be obtained using an open surgical procedure.
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LastUpdate: 2016-05-11 09:46:27