Diagnosing a brain tumor usually begins with a neurological exam by the neurologist, which includes checking vision, hearing, balance, coordination and reflexes. Depending on those results, the physician may request one or more tests described below. A biopsy is usually required to diagnose the type of brain tumor.
A CT scan uses a sophisticated X-ray machine linked to a computer to produce detailed, two-dimensional images of the brain. The patient lies still on a movable table that's guided into what looks like an enormous doughnut where the images are taken. A special dye may be injected into the bloodstream after a few CT scans are taken. The dye helps make tumors more visible on X-ray. A CT scan is painless and generally takes less than 10 minutes.
This scan uses magnetic fields to generate images of the brain. The patient lies inside a cylindrical machine for approximately an hour. MRI scans are particularly useful in diagnosing brain tumors because they outline the normal brain structures in great detail. Sometimes a special dye is injected into the bloodstream during the procedure (MRI angiogram). The dye can help distinguish tumors from healthy tissue.
This test involves injecting a special dye into the arteries that go to the brain. The dye, which flows through the blood vessels in the brain, can be seen on X-ray. This test helps locate blood vessels in and around a brain tumor. MRI angiograms can often be done in place of this test.
An X-ray of the head can show alterations in skull bones that could indicate a tumor. It can also show calcium deposits, which are sometimes associated with brain tumors. However, an X-ray is far less sensitive than brain scans and is used less often.
A biopsy is usually required to diagnose a brain tumor and confirm its type. In a biopsy, a piece of tumor is removed for examination under a microscope. A biopsy can be perfomed separately or as part the surgery to remove the tumor.
A neuropathologist examines the tissue to determine the kind of tumor. This analysis should be performed by a pathologist who specializes in brain tumors. Correctly identifying the type of tumor is crucial to receiving the proper treatment. Studies have shown that the diagnosis may change substantially for at least one-third of patients when pathological review is performed by an experienced neuropathologist. Mayo's neuropathologists are internationally known for their expertise in diagnosing brain tumors.
Read more about brain tumor biopsies on the brain tumor pages.