1. Neuro Oncology: The Role of Neuroradiology
Mary Gawne-Cain
Department of Neuroradiology
Southampton University Hospitals Trust

2. How does neuroradiology assist the neuro oncology team?

3. The Basic Kit

4. CT
Computed tomography
Uses x-rays
Contrast – iodine based

5. MRI Magnetic Resonance Imaging Strong magnetic field
Metal – artefact, movement
Pacemakers!!
Size of bore

6. Neuroradiology Roles Diagnosis Staging Localisation Surveillance
Complications

7. Diagnosis
Diagnosis
Staging
Localisation
Surveillance
Complications

8. Acoustic Neuroma
A: CT soft tissue B: CT bone C: MRI with Gad

9. Brainstem Glioma
Axial T Sagittal T Coronal FLAIR

10. Abscess vs Tumour A B

11. Abscess vs Tumour A B

12. DWI
ADC B A
Tumour Abscess

13. Staging Local Spread incl meningeal Metastatic Meningeal Spread Brain
Spine
Diagnosis
Staging
Localisation
Surveillance
Complications

14. Tumours with Meningeal Spread
Germinoma
PNET and medulloblastoma
Ependymoma
(Glioma / Astrocytoma)
(Metastasis from body)

15. All Children with Posterior Fossa Tumours Should have Spinal Imaging Before Surgery

16. 12yr boy SB

17. Spine Screening
Clear SB

18. Another Case

19. Surgical Workup Localisation is the commonest
Define anatomy (e.g. trans petrous)
Vascular Supply
Vascular Occlusion
Functional
WADA
fMRI
Diagnosis
Staging
Localisation
Surveillance
Complications

20. Stereotactic Localisation
SB – biopsy: germinoma

21. Another Biopsy
Stereo MRI
Post biopsy check CT

22. ? Sagittal Sinus Patent

23. fMRI - language R L

24. Surveillance
Diagnosis
Staging
Localisation
Surveillance
Complications

25. Serial Studies SB
Diagnosis Weeks Months

26. Complications Diagnosis Staging Localisation Surveillance

27. Hydrocephalus
Obstructive hydrocephalus due to posterior fossa tumour

28. Hydrocephalus
Communicating hydrocephalus due to meningeal deposits

29. Optic Nerve / Chiasm Compression
Pituitary adenoma

30. Summary Neuroradiology is used for Tumour diagnosis Staging
Surgical workup
Post surgical check
Radiotherapy planning
Surveillance

31. But don’t forget….
Not all lumps are tumours
Arachnoid Cyst