Brain tumors are amongst the most devastating of all malignant diseases and are difficult to diagnose, as well as challenging to treat. Over the last 50 years, the incidence of brain tumors has appeared to be steadily rising, with the National Cancer Institute estimating that 21 810 men and women in the United States will be diagnosed with cancer of the brain and other central nervous system (CNS) tumors in 2008; of these individuals, 57% will die from their disease.
The epidemiology of brain tumors is complex and appears to be dependant on age, with gliomas occurring mainly in the adult population. They are the most common type of primary brain tumor in adults, accounting for 50% of all primary CNS tumors. For the most part, there are no risk factors associated with brain tumors, the exception being hereditary cancer syndrome, which is associated with selected tumors. Although there are theories attempting to relate environmental factors, such as cell phone usage, to an increased risk of developing a brain tumor, no association has been established.
Neuroimaging has assumed an important role in the care of patients suffering from brain tumors. Advances in CNS imaging technology have resulted in improvements in the accuracy of diagnosis and treatment of these patients. This article will provide a summary of the incidence, pathological classification, diagnosis, and staging of brain tumors. The role of imaging in the diagnosis and treatment of gliomas will be discussed with particular reference to computed tomography, magnetic resonance imaging, and positron emission tomography. In addition, current treatment strategies, including surgical and radiation therapy procedures, chemotherapy, and targeted therapies, will be reviewed.
After reading this article, the participant should be able to:
- Classify the different tumors of the central nervous system.
- Describe the epidemiology, clinical features, and diagnostic procedures for gliomas of the brain.
- Identify the current treatment options for adult patients with gliomas of the brain.
- Discuss the role of computed tomography, magnetic resonance imaging, and positron emission tomography in the diagnosis, treatment planning, and assessment of treatment effects in gliomas of the brain.