Radiologic Evaluation of Intracranial Tumors

Radiologic Evaluation of Intracranial Tumors
Presentation by:Todd Gourdin M-IV

Available Modalities

1)X-ray
2)CT
3)MRI
4)Nuclear Medicine


X-ray
* Primarily of historical interest since the onset of CT in 1974.
* Was useful for detecting increased intracranial pressure and intracranial calcifications.

Craniopharnygioma

CT
* Most intracranial neoplasms are visible on CT
* Tumors may be hypodense, isodense, or hyperdense on a noncontrast CT depending on tumor histology and location
Pilocytic Cerebellar Astrocytoma
Metastatic Lesion
Why not MRI them all???

* MRI is generally preferable to CT for evaluating intracranial neoplasms
* CT is preferred for visualizing tumor calcification or intratumor hemorrhage.

Commonly Calcified and Hemorrhagic Lesions
Glioblastoma Multiforme
MRI
Noncontrast MRI of Meningioma
Advanced MRI Techniques
Proton Magnetic Resonance Spectroscopy
Perfusion weighted MRI
MRI-guided Surgery
MRI guided stereotactic biopsy
Brain surface imaging
Interventional MRI
Brain Surface Imaging
Nuclear Medicine
SPECT(Single Photon Emission Computed Tomography)
Diagnosed by SPECT as a high-grade glioma and confirmed post-resection
PET(Positron Emission Tomography)
Radionuclides useful for PET analysis of intracranial tumors include:
Fluorodeoxyglucose
C methionine
F a-methyl tyrosine
Advantages of PET over SPECT:
Disadvantages of PET:
PET scan of Language Center
Classification of Intracranial Neoplasms
GBM
* Hallmark finding is tumor necrosis
* Often cross the midline
* Extremely poor prognosis
Tumors of Nerve Sheath – Schwannoma, Neurofibroma
Bilateral schwannomas in NF type 2
Meningeal tumors – meningioma
Meningioma
Lymphoma
Lymphoma on noncontrast/contrast CT
Metastasis
Metastases
References

Radiologic Evaluation of Intracranial Tumors.ppt