Imaging
Imaging plays an important role in determining how extensive the cancer is. During imaging, the following are studied.
- Exact location of the primary tumor (primary site)
- Tumor size
- Whether the tumor has extended into the bone
- Spread to adjacent tissues or organs
- Sites of distant metastases or drop metastasis
- Post treatment: to determine how much of the tumor was left behind
| Modality | Utility |
|---|---|
| Magnetic Resonance Imaging (MRI) with gadolinium | Provides a detailed picture of the brain and spinal cord. The gadolinium is injected into a vein and collects around the cancer cells. MRIs help with location of the tumor, size, extension to other sections, or whether the patient may be a surgical candidate |
| Single Photon Emission Computed Tomography Scan (SPECT Scan) | Procedure to find malignant cells in the brain. Radioactive substances are injected into a vein or inhaled through the nose. As the substance travels through the brain, a camera rotates around the head and takes picture of the brain. Increased blood flow and more activity are seen in areas where cancer is growing. In post-therapy imaging, SPECT, along with PET, can help differentiate between the recurrence of a brain tumor versus radiation necrosis. |
| MR Spectroscopy (MRS) | May be during an MRI. The MRS is used to diagnose tumors based on the chemical make-up.
Allows detection and measurement of specific metabolites within tumors and normal brain tissue. It is used in the prediction of tumor grade, selection of biopsy sites, and monitoring post-treatment for only a subsite of tumors that have a favorable diagnosis. Not currently used for routine brain imaging. |
| MR Perfusion | Used as part of the evaluation of brain tumor for diagnosis, treatment, and surveillance.
Can provide information on aggressiveness of tumors, identify areas for biopsy. This imaging process is still fairly new and still has some limitations. It is recommended that this be used in conjunction with other standard imaging |
| Functional MRI | Allows indirect mapping of brain neuronal activity. Used primarily as a pre-treatment tool.
Used to evaluate a patient’s sensory, visual and language tasks. This imaging process is still fairly new and still has some limitations. It is recommended that this be used in conjunction with other standard imaging. |
| Positron Emission Tomography Scan (PET) | Procedure to find malignant tumor cells in the body. Glucose is injected into a vein. The PET scanner rotates around the body and produces a picture of where glucose is being used in the brain. Malignant tumor cells are more active and take up more glucose than normal cells |
See Diagnostic Tests | SEER Training website for more information on imaging.
Document imaging details in NAACCR #2530: Text-Dx Proc-X-ray scan
Document results of Scopes in NAACCR Item #2540: Text-Dx Proc-Scopes
Updated: September 23, 2026
Suggested Citation
SEER Training Modules: Imaging. U.S. National Institutes of Health, National Cancer Institute. Cited 24 September 2026. Available from: https://training.seer.cancer.gov.