How Brain Tumors Are Diagnosed

Diagnosing and treating a brain tumour involves a series of advanced procedures to confirm its presence, understand its nature, and determine the best course of action. Early and accurate diagnosis is crucial for effective treatment and better outcomes.

The diagnostic process for brain tumours is designed to identify abnormalities, determine the tumour type, and guide treatment planning. Below are the key diagnostic methods:

Neurological Examination

A neurological exam assesses brain function by testing:

• Vision
• Hearing
• Balance and coordination
• Reflexes and strength

While this exam cannot directly detect a brain tumour, it helps identify areas of the brain that may be affected, guiding further diagnostic tests.

Imaging Tests

Imaging tests are essential for visualising the brain and identifying abnormalities.

• CT Scan:

  A computed tomography (CT) scan uses X-rays to create detailed images of the brain. It is often the first imaging test performed when symptoms like headaches or seizures are present. CT scans provide quick results and are widely available.

• MRI:

  Magnetic resonance imaging (MRI) is the preferred method for detecting brain tumours. It uses strong magnets and radio waves to produce detailed images of the brain.

Advanced MRI Techniques:

• Functional MRI (fMRI): Identifies brain areas responsible for critical functions like speech and movement.
• Magnetic Resonance Spectroscopy (MRS): Measures chemical levels in tumour cells to determine the tumour type.
• Magnetic Resonance Perfusion: Assesses blood flow in different tumour areas, helping identify the most active regions.
• PET Scan: Positron emission tomography (PET) uses a radioactive tracer to detect rapidly growing tumour cells. It is particularly useful for identifying aggressive tumours but less effective for slow-growing or benign ones.

Brain Biopsy

A biopsy is often required to confirm the diagnosis and determine the nature of the tumour. This involves removing a small tissue sample for laboratory analysis.

• Surgical Biopsy: Performed during surgery to remove the tumour.
• Stereotactic Needle Biopsy: A minimally invasive option for tumours in hard-to-reach areas.

Brain Tumor Grading

Once diagnosed, brain tumours are graded based on how the cells appear under a microscope:

• Grade 1: Slow-growing cells that closely resemble healthy brain cells.
• Grade 4: Rapidly growing cells that look very different from normal cells.

The tumour grade helps healthcare providers assess its aggressiveness and tailor the treatment plan accordingly.

Treatment Options for Brain Tumors

Treating a brain tumour requires a personalised approach based on factors such as the tumour’s type, size, location, and grade. Below are the most common treatment options available:

Surgery

Surgery is often the first step in treating brain tumours. The primary goal is to remove as much of the tumour as possible while preserving healthy brain tissue.

• Craniotomy: The most common surgical method, where a section of the skull is temporarily removed to access the tumour.
• Endoscopic Surgery: A minimally invasive technique using a thin tube with a camera, often performed through the nasal cavity.

In some cases, only part of the tumour can be removed to alleviate symptoms and improve the patient’s quality of life.

Radiation Therapy

Radiation therapy uses high-energy beams to destroy tumour cells. It is often used after surgery to eliminate any remaining tumour cells.

• External Beam Radiation: Targets the tumour from outside the body.
• Proton Therapy: A more precise form of radiation that minimises damage to surrounding healthy tissue.

Radiosurgery

Stereotactic radiosurgery delivers a highly focused dose of radiation to the tumour. This non-invasive procedure is typically completed in one or a few sessions.

• Linear Accelerator (LINAC) Radiosurgery: Utilises X-rays for precise targeting. Modern LINAC systems, when paired with advanced tools such as ExacTrac Dynamic, can further improve accuracy, reduce treatment time, and allow therapy to be delivered comfortably while protecting nearby healthy brain tissue.
• Gamma Knife Radiosurgery: Uses gamma rays to target the tumour.

Chemotherapy

Chemotherapy involves the use of drugs to kill tumour cells. These drugs can be administered:

• Orally
• Intravenously
• Directly into the brain during surgery

Chemotherapy is often combined with radiation therapy for more effective results.

Targeted Therapy

Targeted therapy uses drugs designed to attack specific molecules within tumour cells. This approach is particularly effective for tumours with identifiable genetic markers.

Preparing for Your Appointment

When you visit your neurologist or neurosurgeon, ensure you're prepared to discuss:

• Symptoms and their progression
• Medical and family history
• List of current medications

It’s also helpful to write down questions such as:

• What treatment options are available for my brain tumour?
• What are the potential risks and benefits of surgery?
• How will this tumour affect my daily life?

Post-Treatment Recovery and Rehabilitation

After treatment, patients may require rehabilitation to regain lost functions. Depending on individual needs, this may include:

• Physical Therapy: To enhance strength and mobility.
• Occupational Therapy: To assist with daily activities.
• Speech Therapy: To address speech or swallowing difficulties.

At Subang Jaya Medical Centre (SJMC), we understand that recovery is a journey. Our multidisciplinary team provides comprehensive support, ensuring patients receive the care they need every step of the way.

Why Early Diagnosis and Treatment Matter

Early and accurate diagnosis is critical for effective treatment and better outcomes. At Subang Jaya Medical Centre (SJMC), our multidisciplinary team of neurologists, neurosurgeons, oncologists, and rehabilitation specialists work collaboratively to provide personalised care for brain tumour patients.

With access to advanced diagnostic tools and treatment options, patients receive world-class care tailored to their unique needs.

Reference:

1. Mayo Clinic Brain Tumor: Diagnosis and Treatment
2. National Cancer Institute Brain Tumor Treatment
3. Johns Hopkins Medicine Brain Tumor Treatment
4. Johns Hopkins Medicine Glioblastoma Multiforme (GBM)
5. Cleveland Clinic Glioblastoma (GBM): What It Is, Symptoms & Prognosis
6. American Cancer Society Treating Brain and Spinal Cord Tumors in Adults