Detection & Treatment

Brain tumours are usually detected through a combination of neurological examination and imaging tests such as MRI or CT scans.

Treatment depends on the type, size, and location of the tumour, as well as the patient’s overall health. Common approaches include surgery, radiotherapy, chemotherapy, targeted therapy, and supportive care to manage symptoms and improve quality of life.

Care is often provided by a multidisciplinary medical team to ensure treatment is tailored to each individual.

Diagnostic Imaging Techniques & Procedures

PET Scan ( Positron Emission Tomography Scan)

A medical imaging test used to detect cancerous cells in the body. A small dose of radioactive sugar is injected into a vein, which is then absorbed by tissues in the body. A PET scan creates images showing how the brain uses this sugar. Cancer cells often appear brighter on the scan because they are more active and consume more sugar than normal cells. This test can also help distinguish between a tumour that is growing and changes caused by treatments like radiotherapy.

Magnetic Resonance Imaging (MRI) with Gadolinium

A medical imaging technique that uses a strong magnet, radio waves, and a computer to produce detailed images of the brain and spinal cord. In some cases, a contrast agent called gadolinium is injected into a vein, which helps highlight areas where tumour cells may be present by making them appear brighter on the scan. This procedure is also known as nuclear magnetic resonance imaging (NMRI).

Computed Tomography Scan (CT/CAT Scan)

This is an imaging test that uses X-rays and a computer to create detailed cross-sectional images of the brain and surrounding skull structures. It is most often done without contrast, but in some cases a contrast dye may be used to provide more detailed information depending on the clinical need.

Cerebral Angiogram

A diagnostic cerebral angiogram is a specialized imaging procedure that uses X-rays and contrast dye to visualize the blood vessels in the brain, head, and neck. It helps doctors assess the structure and flow of blood within these vessels and identify any abnormalities.

Myelogram / Cisternogram

A myelogram or cisternogram is an imaging procedure used to evaluate the flow of cerebrospinal fluid (CSF) and detect any abnormalities. It can help identify areas where fluid may be trapped, such as in arachnoid cysts, as well as CSF leaks outside the central nervous system or blockages affecting normal circulation around the brain and spinal cord.

This detailed imaging helps diagnose complex conditions such as arachnoid cysts, Chiari malformations, intracranial hypotension, and CSF leaks, supporting accurate treatment planning and improved patient outcomes.

World Health Organization (WHO) Tumor Grading System for Adult Brain Tumors

The World Health Organization (WHO) grading system is used to classify adult brain tumours based on how abnormal the tumour cells look under a microscope and how likely they are to grow and spread.

Grade I (Low-grade, least aggressive)

Grade 1 brain tumours are slow-growing and considered the least aggressive type.

They are usually well-defined and do not typically spread into nearby brain tissue. In many cases, they can be treated effectively with surgery alone, especially if complete removal is possible.

Examples include tumours such as pilocytic astrocytoma and some types of meningioma.

Many patients do well after treatment, although long-term follow-up is still important to monitor for any return of the tumour.

Grade II

(Low-grade but infiltrative)

Grade 2 tumours grow slowly but have a tendency to extend into surrounding brain tissue. Because of this, they are more likely than grade 1 tumours to return or gradually progress over time.

Treatment often involves surgery, and depending on the situation, may also include radiotherapy or chemotherapy, particularly if the tumor cannot be fully removed or shows signs of change.

Grade III (High-grade, more aggressive)

Grade 3 brain tumours are malignant and grow more quickly. They are more likely to invade nearby healthy brain tissue and require a combination of treatments such as surgery, radiotherapy, and chemotherapy.

Symptoms may become more noticeable as the tumour progresses and can include headaches, seizures, or changes in neurological function such as speech or movement difficulties.

Regular imaging and follow-up are important due to the risk of recurrence.

Grade IV - (Most aggressive)

Grade 4 tumours are the most aggressive form of brain cancer.

They grow rapidly, often develop their own blood supply, and may contain areas of necrosis (dead tissue). A common example is glioblastoma.

Treatment usually involves a combination of surgery, radiotherapy, and chemotherapy, aimed at slowing progression and managing symptoms.

References

Board, E. (2021). WHO classification of tumours of the central nervous system [... presented in this book reflects the views of the WHO Classification Tumours Editorial Board that convened via video conference 24-26 August 2020]. Lyon Internat. Agency For Research Of Cancer.

Diagnostic Cerebral Angiogram. (2026). UC Health. https://www.uchealth.com/en/treatments-and-procedures/diagnostic-cerebral-angiogram#item-1-253732772

How We Diagnose Brain Tumors | Dana-Farber Cancer Institute. (n.d.). Www.dana-Farber.org. https://www.dana-farber.org/cancer-care/types/brain-tumors/diagnosis

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Jones J, CT head (protocol). Reference article, Radiopaedia.org (Accessed on 08 Jun 2026) https://doi.org/10.53347/rID-8996

Myelogram and Cisternogram | Pacific Neuroscience Institute. (2026, March 4). Pacific Neuroscience Institute. https://www.pacificneuroscienceinstitute.org/patient-care/services-diagnostics/myelogram-and-cisternogram/

What are the Different Brain Tumor Grades? (2025, October 30). Tisch Brain Tumor Center. https://tischbraintumorcenter.duke.edu/blog/what-are-different-brain-tumor-grades-0

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