Obligatory medical device diagnostics.
- Magnetic resonance imaging of the skull (cranial MRI or cMRI) (T1 with and without contrast, T2 and FLAIR sequences) [gold standard][low-grade gliomas: mildly hypointense; usually without perifocal edema and without contrast enhancement; glioblastomas: Centrally necrotic, marginal contrast-enhancing mass showing marked perifocal edema]Note: “Barrier disruption” in terms of contrast uptake in tumor tissue is considered indicative of WHO grade III or IV malignant glioma.
- Computed tomography of the skull (cranial CT or cCT) with intravenous contrast agent – for tumors with calcifications or bone infiltration.
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics and obligatory medical device diagnostics – for differential diagnostic clarification.
- Encephalogram (EEG; recording of the electrical activity of the brain).
- X-rays of the skull, in two planes
- Stereotactic biopsy with histological workup.
- Positron emission tomography (PET; nuclear medicine procedure that allows cross-sectional imaging of living organisms by visualizing the distribution patterns of weak radioactive substances).
- MR proton spectroscopy (radiological technique that allows better differentiation of neoplastic from non-neoplastic brain lesions through measurable metabolite signal intensities (choline, N-acetyl aspartate, creatine, llactate, lipids))
