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Treating Pediatric Brain Tumors: How Advanced Imaging Technologies Help

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Little girl asking her doctor questions as family looks at MRI brain images.

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If your child was recently diagnosed with a brain tumor, you may feel overwhelmed by the uncertainties ahead. However, with innovative advances in noninvasive brain imaging, you can feel confident that your child is getting the most targeted care possible. Your child will probably undergo several imaging scans from the time of diagnosis through treatment to ensure precise, appropriate and safe care.

Alan Cohen, M.D., director of pediatric neurosurgery at Johns Hopkins Children’s Center, summarizes the imaging tools most commonly used to diagnose and treat pediatric brain tumors today. These tools help ensure an earlier diagnosis and more effective treatments while keeping children’s safety a top priority.

CT and MRI Scans

As noninvasive imaging technologies have become more sophisticated in recent decades, doctors have learned a tremendous amount of information about pediatric brain tumors. With better pictures, they can diagnosis brain abnormalities better — and sooner — than before. Today, doctors rely on two main types of imaging to diagnose brain tumors in children:

  • CT: First performed in the early 1970s, CT (computed tomography) imaging has revolutionized neurosurgery. With more detailed images from specialized X-ray technology, CT scans help doctors diagnose many abnormalities that occur inside the brain, including pediatric brain tumors.
  • MRI: Developed in the late 1970s and 1980s, MRI (magnetic resonance imaging) machines use powerful magnets to give very precise pictures of brain tumors. MRI requires no radiation — which can sometimes cause health problems in the long run — making it an ideal diagnostic option for children.

Planning Pediatric Brain Tumor Treatment with Advanced Imaging Scans

Certain imaging technologies help doctors plan for the safest and most effective treatment of a pediatric brain tumor. These include:

  • fMRI: Functional MRI detects blood flow. It can be particularly helpful when a tumor’s location requires doctors to operate near crucial areas of the brain, such as the motor cortex, which controls movements. An fMRI scan can tell doctors where these important structures are in relation to a tumor so the doctor can perform a safer surgery.
  • Diffusion tensor imaging: This imaging, based on MRI technology, gives detailed images of the “fiber tracts” in the brain. When doctors know where the motor and visual fibers are, they can plan the safest corridor or path on which to make their delicate incisions. Using the detailed imaging, surgeons disturb the least amount of functional brain tissue when removing a brain tumor.
  • MRI image guidance: Think of this as a GPS system for the brain. Using preoperative imaging studies, such as MRI with computer technology, doctors get the guidance that helps them choose the safest and most direct movements during neurosurgery.

Imaging Tools for Pediatric Brain Tumor Surgery

Imaging technology used during neurosurgery can offer doctors even more insight into a tumor’s location, adding another layer of safety and effectiveness. Two examples include:

  • Intraoperative ultrasound: Using a sonar probe over the outside of the brain, doctors can see what’s underneath. The imaging helps guide surgery and can ensure doctors remove the entire tumor during surgery.
  • Intraoperative MRI: In certain instances, doctors may have a child undergo a special MRI scan while he or she is still under general anesthesia in the operating room. The MRI scan helps ensure the most successful surgery result while avoiding putting a young child in a follow-up scan a few days after surgery.

Advances in surgical technologies have also helped doctors treat children with brain tumors more effectively and safely.

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