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- Imaging
- • Imaging has been conventionally done by CT for the brain and myelography for the spinal cord. Recently,
- MRI imaging with gadolinium enhancement has been shown to be extremely sensitive, useful and simpler for
- both the brain and spinal cord.
- • Images of the entire brain and spinal cord should be done for tumors that may spread to the spinal cord
- (medulloblastoma, ependymoma, intracranial germ cell tumors, pineal tumors, cerebral neuroblastoma—
- PNET).
- • Bone scans are sometimes done in medulloblastoma because this tumor may spread outside the central nervous
- system, especially to bone.
-
- Endoscopy and Biopsy
- • Tumors of the brain stem, the medulla and the pons (brain stem glioma) may be biopsied. The procedure is
- risky. They cannot be removed surgically (radiation therapy is the standard treatment). Stereotactic needle
- biopsy techniques may enable biopsy to be done when it could have an effect on treatment—for example, if it
- is not certain that a mass in this area is malignant , if the tumor grows outwards and protrudes into the
- ventricles or if there is a need to remove part of the tumor because of pressure symptoms.
- • Biopsy of optic tract glioma is not always possible because it is difficult to expose the area surgically.