ABSTRACT
Imaging is indispensable for the management of neoplastic disorder affecting the brain. The first step in this process is the detection of a lesion causing the clinical symptoms of the patient. When an abnormality is found, the next task is to elucidate its pathologic significance and to decide whether it is the cause of the clinical symptoms. The next step is then the differential diagnosis of the brain lesion and its basic classification as neoplastic, inflammatory, vascular, or of developmental origin. If the lesion is thought to be a neoplasm, further differential diagnosis should place it into one of the relevant subgroups such as primary or metastatic, congenital or acquired, glial, neuronal, lymphomatous, or embryologic. Imaging should then supply an evaluation of the grade of malignancy and the prospective speed of proliferation. If all these tasks have been accomplished the role of imaging is far from over. The planning of any treatment requires the evaluation of tumor location and extension relative to eloquent brain areas. After any therapeutic procedure, imaging is required to monitor the extent of resection and the response to radio-and chemotherapy. Follow-up scans should detect tumor recurrence and indicate treatment side effects such as radionecrosis or leukoencephalopathy.
