Brain tumor imaging and cancer management: the neuro-oncologists perspective

Brain tumors remain a significant cause of morbidity and mortality and are often refractory to treatment. Neuroimaging, in particular magnetic resonance imaging (MRI) and associated techniques, has become an important tool for the neuro-oncologist in the management of brain tumors. Magnetic resonance imaging is the most sensitive method to demonstrate the presence of a mass in the brain and can often narrow the differential diagnosis with nonneoplastic lesions such as cerebral abscess and subacute infarction. Once the diagnosis has been confirmed, MRI is essential for initial treatment planning, including surgical resection and radiation therapy. In selected patients, serial MRI will also be necessary to evaluate for response during adjuvant chemotherapy and to monitor for treatment-induced toxicity. New magnetic resonance techniques such as magnetic resonance spectroscopy, diffusion-weighted imaging, and perfusion-based imaging methods will also be discussed where applicable.