Imaging of Brain Tumors

OBJECTIVE This article focuses on neuroimaging as an essential tool for diagnosing brain tumors and monitoring response to treatment.

LATEST DEVELOPMENTS Neuroimaging is useful at all stages of brain tumor care. Technologic advances have improved the clinical diagnostic capability of neuroimaging as a vital complement to history, examination, and pathologic assessment. Presurgical evaluations are enriched by novel imaging techniques, through improved differential diagnosis and better surgical planning using functional MRI (fMRI) and diffusion tensor imaging. The common clinical challenge of differentiating tumor progression from treatment-related inflammatory change is aided by novel uses of perfusion imaging, susceptibility-weighted imaging (SWI), spectroscopy, and new positron emission tomography (PET) tracers.

ESSENTIAL POINTS Using the most up-to-date imaging techniques will facilitate high-quality clinical practice in the care of patients with brain tumors.

Address correspondence to Dr Justin T. Jordan, 55 Fruit St, Yawkey 9E, Boston, MA 02114, [email protected].

RELATIONSHIP DISCLOSURE: Dr Jordan has received personal compensation in the range of $0 to $499 for serving as a consultant for Atheneum Partners, EM Partners, GLG Pharma, and Guidepoint Global, LLC; in the range of $500 to $4999 for serving as a consultant for Creative Educational Concepts, LLC, and Texas Health Resources; and in the range of $5000 to $9999 for serving as a consultant for Children’s Tumor Foundation, Navio Theragnostics, Inc, and Recursion and on a scientific advisory board for Recursion. Dr Jordan has stock in The Doctor Lounge and Navio Theragnostics, Inc, has received publishing royalties from Elsevier, and has noncompensated relationships as a board member with ABA Academy, Neurofibromatosis Northeast, Neurofibromatosis Network, and the United Council for Neurologic Subspecialties that is relevant to AAN interests or activities. The institution of Dr Jordan has received research support from The Burke Foundation, the Department of Defense, and the National Institutes of Health. Dr Gerstner has received personal compensation in the range of $500 to $4999 for serving on a data safety monitoring board for Midatech Pharma PLC and in the range of $50,000 $99,999 for serving as an officer or member of the board of directors for the Gerstner Family Foundation. The institution of Dr Gerstner has received research support from the National Cancer Institute.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Drs Jordan and Gerstner discuss the unlabeled/investigational use of mitogen-associated protein kinase (MAPK) pathway with MAP-ERK kinase (MEK) inhibitors for the treatment of MAP kinase-altered tumors and various MRI and positron emission tomography (PET) techniques not approved for the imaging of brain tumors.