If our specialists think that your child may have a glioma, we will administer a variety of tests and procedures to determine the type and location of the tumor. Our Sheba physicians have extensive experience and use of the latest technologies to diagnose each individual child as quickly and efficiently as possible.
To diagnose a childhood glioma, we may perform the following tests:
Physical exam and case history
We will examine your child’s body thoroughly to check overall signs of health. Our doctors will also ask a series of questions about any signs and symptoms. A review of the child’s medical condition and family medical history will also be discussed.
Our physician will perform tests and ask questions to check the brain, spinal cord, and nerve function. A neurological examination checks coordination, mental status, and the child’s ability to walk normally, evaluating the function of the muscles, senses, and reflexes.
This quick imaging procedure creates a 3D picture of the inside of the body. The detailed, cross-sectional views show if there are any abnormalities or tumors. A CT scan may also be used to measure the size of the tumor if a glioma has already been diagnosed.
MRI (magnetic resonance imaging) with gadolinium
This type of imaging generates detailed pictures of areas inside the brain and spinal cord. We will inject a contrast substance called gadolinium into a vein, and this substance collects around cancer cells so they appear brighter in the picture. Gliomas generally have a characteristic appearance on an MRI, and our physician may be able to identify the particular tumor based on this radiology scan. An MRI may also be performed in the first few days following surgery to check how much tumor (if any) remains after removal.
A biopsy is typically the best way to confirm a final diagnosis about the specific type of glioma. This information is essential for designing the treatment program. A neurosurgeon performs the biopsy procedure by removing a small piece of tissue from the tumor. A pathologist then analyzes the tissue sample under a microscope to inspect for signs of cancer. Sometimes (depending largely on where the tumor is located) the entire tumor is removed during surgery instead of performing a separate biopsy.
When children have high-grade gliomas, a lumbar puncture (also called a spinal tap) may be performed to inspect for spread of the tumor to the CSF (spinal fluid). In this test, a doctor will remove a small sample of spinal fluid from near the base of the spine and a pathologist will examine it under a microscope.
We may run laboratory tests on a tissue sample taken from the tumor to identify particular genes and proteins that are unique to the child’s glioma. The results of this molecular profiling can help us determine whether your child is a candidate for targeted therapy as a treatment option.