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    Diagnosing Brain Cancer

    Exams and Tests

    Findings of your medical interview and physical exam will probably suggest to your health care provider that you have a problem with the brain or brain stem.

    In most cases, you will have a CT scan of the brain. This test is like an X-ray, but shows more detail in three dimensions. Usually, a harmless dye is injected into your bloodstream to highlight abnormalities on the scan.

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    More often, the MRI scan is being used instead of a CT scan for suspected brain tumors. This is because MRI has a higher sensitivity for detecting the presence of, or changes within, a tumor. Currently, however, most institutions still use the CT scan as the first diagnostic test.

    Skull X-rays are no longer widely used to diagnose brain cancer.

    People with brain cancer often have other medical problems; therefore, routine lab tests may be performed. These include analysis of blood, electrolytes, liver function tests, and a blood coagulation profile.

    If your mental status has been the major change, blood or urine tests may be done to detect drug use.

    If your scans indicate the presence of a brain tumor, you will be referred to a cancer specialist, called an oncologist. If one is available in your area, you should be referred to a specialist in brain tumors, called a neuro-oncologist.

    The next step in diagnosis is confirmation that you have a cancer, usually by taking and testing a sample of the tumor. This is called a biopsy:

    • The most widely used technique for obtaining a biopsy is surgery. The skull is opened, usually with the intention of removing the whole tumor, if possible. A biopsy is then taken from the tumor.
    • If the surgeon is unable to remove the entire tumor, a small piece of the tumor is removed.
    • In some cases, it is possible to collect a biopsy without opening the skull. The exact location of the tumor in the brain is determined by using a CT or MRI scan while the head is held still in a frame. A small hole is then made in the skull and a needle guided through the hole to the tumor. The needle collects the biopsy and is removed. This technique is called stereotaxis, or stereotactic biopsy.
    • The biopsy is examined under a microscope by a pathologist (a doctor who specializes in diagnosing diseases by looking at cells and tissues).

    WebMD Medical Reference from eMedicineHealth

    Reviewed by Sujana Movva, MD on March 02, 2014
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