Brain tumors Radio diagnosis and therapy
- 1. Brain Tumors Tbilisi State Medical University By Goran Baiz 6TH year 2018
- 2. Brain Tumor • A brain tumor is a collection, or mass, of abnormal cells in yourbrain. Your skull, which encloses your brain, is very rigid. Any growth inside such a restricted space can cause problems. Brain tumors can be cancerous (malignant) or noncancerous (benign) • _Primary tumor • _Secondary tumor
- 3. Secondary brain tumors • Non-brain origin = Cancer metastasis – Most common – 25-45% of cancer patients • Lung: >50% of all; most common in men • Breast: Most common in women • Melanoma: Highest propensity for brain – 50% of melanoma patients develop brain mets; Multiple • Renal Cell • Colorectal • Any primary can metastasize to the brain
- 4. Primary brain tumors • Meningioma (35%) • Glioma (30%) – Astrocytoma • Glioblastoma – Oligodendroglioma – Oligoastrocytoma – Ependymoma • Pituitary Adenoma (13%) – Within skull – Beneath brain Skin Skull Meninges Brain Neuron Astrocyte Oligodendrocyte Ependyma
- 5. Is this cancer? Benign • Slow growing • Non-invasive • Does not spread • Less likely to recur Malignant • Fast growing • Aggressively invasive • May spread distantly • More likely to recur
- 6. Presentation • Generalized symptoms and signs → Elevated intracranial pressure • Headaches (50%) – New or different – Worsening over time – Worse on awakening, them improve – Other symptoms • Seizures (30%) • Cognitive change (30%) • Personality change (25%) • Nausea/vomiting (15%) • Blurred vision/papilledema • Lethargy
- 7. Radiological Diagnosis MRI of the head: Magnetic resonance imaging (MRI) uses a powerful magnetic field, radio frequency pulses and a computer to produce detailed pictures of organs Brain fMRI: Functional magnetic resonance imaging (fMRI) is a relatively new procedure that uses MR imaging to measure the tiny metabolic changes that take place in an active part of the brain CT of the head: Computed tomography (CT) scanning combines special x-ray equipment with sophisticated computers to produce multiple images or pictures of the inside of the body. It can detect brain tumors as well as help plan radiation therapy if that is the treatment of choice
- 8. • PET and PET/CT of the head: A positron emission tomography (PET) scan is a diagnostic examination that uses a small amount of radioactive material (called a radiotracer) to diagnose and determine the severity of a variety of diseases. • Cerebral angiography: This imaging test is a minimally invasive medical test that uses x-rays and an iodine- containing contrast material to produce pictures of blood vessels in the brain. • Spectroscopy is a scientific measurement technique. It measures light that is emitted, absorbed, or scattered by materials and can be used to study
- 9. Radiotherapy in Brain Tumors • Types • Intensity-Modulated Radiation Therapy • Stereotactic Radiosurgery • External Beam Therapy • Linear Accelerator • Gamma Knife • Brachytherapy
- 10. Intensity modulated radiation therapy (IMRT) uses advanced software to plan a precise dose of radiation, based on tumor size, shape and location. A computer- controlled device called a linear accelerator delivers radiation in sculpted doses that match the 3D geometrical shape of the tumor, including concave and complex shapes.
- 11. Stereotactic radiosurgery • (SRS) is a non-surgical radiation therapy used to treat functional abnormalities and small tumors of the brain. It can deliver precisely-targeted radiation in fewer high- dose treatments than traditional therapy
- 12. External Beam Therapy (EBT) is a method for delivering high- energy x-ray or electron beams to a patient's tumor. Beams are usually generated by a linear accelerator and targeted to destroy cancer cells while sparing surrounding normal tissues
- 13. Linear Accelerator • Linacis a device that uses high Radio-Frequency (RF)electromagne Dc waves to accelerate to high energies in a linear path, inside a tube like structure called the accelerator waveguide.. medical linacs is about 3 billion Hertz (cycles/sec)
- 14. Gamma Knife • radiosurgery is a type of radiationtherapy used to treat tumors, vascular malformations and other abnormalities in the brain.. Neurosurgeons prefer Gamma Knife radiosurgery, than brain surgery
- 15. Brachytherapy • radiotherapy delivered by placing radioactive sources directly into the tumor, was initially thought to be the solution to this problem
- 16. References • American Cancer Society • Central Brain Tumor Registry of the United States (CBTRUS) • Lamszus K. Meningioma pathology • National Cancer Institute Physician Data Query