Brain and Spine Tumors Screening

Currently, there are no standardized screening methods to detect a brain tumor before a per-son develops symptoms. That’s why Winship Cancer Institute of Emory University’s team of highly trained neurosurgeons, radiation oncologists, medical neuro-oncologists, neuropa-thologists, neuroradiologists, neuro-ophthalmologists and research scientists are doing every-thing they can to develop treatment methods and therapies that will help fight the cancer and keep it from recurring.

While pre-screening capabilities are still being developed for people with brain cancer, there are advanced methods that can help in brain tumor detection as soon as symptoms arise. These techniques are used for the most common types of brain cancer, including glioblastoma, gliomas (both astrocytomas and oligodendrogliomas), meningioma, pituitary tumors and pineal tumors.

Detection typically begins with a physical and neurologic exam, followed by imaging tests and, if necessary,  a biopsy.

• Physical and neurologic exam: This exam is used to assess your general health, mental status, sensation, reflexes and coordination. If there are any unusual signs or symptoms -- for instance, intense headaches, changes in vision, hearing or speech, trouble with balance and walking, and/or extreme mood swings -- it could indicate a neurologic issue that needs further evaluation.
• Biopsy: A sample of tissue is taken and examined under a microscope to see if any cancerous cells are present.
• Advanced brain imaging: Winship uses multiple imaging modalities to detect a brain or spinal tumor. These can be used to detect glioblastomas, gliomas, meningiomas, pituitary tumors as well as pineal tumors:
  
  • Computed tomography (CT). Using X-ray and computer technology, a CT scan takes cross-sectional images of the brain to detect the presence of any abnormal mass.
  • Magnetic resonance imaging (MRI), including functional MRI (fMRI). Using powerful magnets and radio waves, this non-invasive method produces advanced images of the inside of the brain.
  • Myelogram. Using contrast dye that is injected into the spinal column and under CT scan, this method is used to detect spinal cord tumors.
  • Arteriogram. Using contrast dye, arteriograms can pinpoint vascular abnormalities that could trigger events or conditions such as an aneurysm, arterial stenosis or thrombosis (blood clot).
  • Magnetic resonance spectroscopy. A non-invasive imaging technique that analyzes the chemical composition of a brain tumor or lesion in the brain, it is most often used to compare healthy brain tissue with abnormal brain tissue. It also provides valuable insight on the type of tumor and its aggressiveness.
  • Diffusion tensor imaging (DTI) tractography. Similar to an MRI, DTI tractography produces more detailed images to see the pathways of information (movement, visual, speech) inside the brain.
  • Perfusion imaging. This technique is often used to see how a brain or spinal tumor is responding to treatment and whether it is growing back. 

Using the above modalities, our brain cancer team at Winship can make an accurate and swift diagnosis. Once this is done, a possible course of treatment can be put into place.

Although it is currently impossible to predict with certainty a person’s genetic or environmental predisposition for developing brain or spinal cancer, there are individuals who are at higher risk of developing brain cancer. Anyone suffering from a particular type of immune system disorder or rare genetic condition can benefit from close monitoring by an oncologist.

High-risk individuals include those who have:

• Neurofibromatosis type 1 (NF1): NF1 is a genetic condition affecting the nervous system outside of the brain and spinal cord. People with NF1 commonly have dark colored spots on the skin, freckles in the underarm and groin as well as benign (non-cancerous) growths along the nerves. These neurofibromas can increase over the course of a person’s life. Some can grow large or turn cancerous and will need surgery to remove them.
• Tuberous sclerosis: This genetic disorder causes benign tumors to grow in the brain and other organs. Tuberous sclerosis can cause seizures, impaired brain development, behavioral problems and kidney issues.
• Von-Hippel-Lindau disease (VHL): This disease is an inherited disorder in which both benign and malignant (cancerous) tumors grow in different parts of the body. The types of tumors usually associated with VHL are hemangioblastomas, which are slow-growing tumors of the central nervous system.

Learn more about brain and spinal tumor detection and diagnosis.