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To diagnose metastatic brain lesions, or area of abnormal tissue, doctors usually conduct a neurological examination and have patients undergo magnetic resonance imaging (MRI) of the brain.
Imaging Studies
Brain tumors can be difficult to diagnose because they can cause a wide variety of symptoms, all of which might also be caused by other diseases. To diagnose a brain tumor, a doctor usually takes a complete medical history and conducts a neurological examination, which includes an MRI of the brain.
A technique called contrast-enhanced MRI -- in which the patient intravenously receives a dye called gadolinium just before the procedure -- is particularly useful in making an accurate diagnosis of brain metastases because it provides very detailed images of normal and abnormal brain tissue. Its resolution and sensitivity are much greater than that of computed tomography (CT) scans, and it is able to detect small tumors, which may be missed on a CT scan. For patients who cannot undergo MRI, such as those with cardiac pacemakers or severe claustrophobia, physicians generally recommend a CT scan.
Biopsy
A biopsy is rarely necessary to diagnose brain metastases, but when appropriate, a small sample of the tumor tissue is performed. In some cases, a lumbar puncture (spinal tap), removing a sample of spinal fluid for study is useful particularly in diagnosing neoplastic meningitis, a type of metastasis in which tumor cells invade the cerebrospinal fluid.
