Conventional and Advanced MRI in Neuro-Oncology

Magnetic resonance imaging (MRI) has become an indispensable tool in the field of neuro-oncology. However, while conventional MRI sequences like T1-weighted, T2-weighted, and T2-weighted fluid-attenuated inversion recovery (FLAIR) imaging are routinely used for diagnosis, treatment planning, and follow-up, they have limitations in terms of both sensitivity and specificity. These limitations are particularly evident when attempting to differentiate between tumor types and grades, assess the degree of tumor infiltration, or distinguish between tumor progression and treatment-related effects. The development of numerous advanced MRI techniques offers an opportunity to overcome these limitations and provide additional information on microstructural and functional characteristics. This chapter will begin by outlining the basic physical principles of MRI. Thereafter, an overview will be provided on conventional MRI and its current limitations in neuro-oncology. Subsequently, it will delve into the most commonly used advanced MRI techniques, including diffusion and perfusion MRI, functional MRI (fMRI), susceptibility-weighted imaging (SWI), and proton magnetic resonance spectroscopy (MRS), and examine their potential clinical applications. Finally, the chapter will touch upon the future prospects of advanced MRI in neuro-oncology. Overall, this chapter aims to provide a comprehensive overview of the role of conventional and advanced MRI in the diagnosis, management, and follow-up of brain tumors.