Advanced magnetic resonance imaging in the study of primary intracranial brain tumors in adults: a state of art review

Intracranial tumors are an important health problem with an annual incidence of primary and secondary central nervous system neoplasms ranges from 10 to 17 per 100,000 persons. Tumor imaging have as fundamental aims: the initial differential diagnosis with the distinction between newly diagnosed brain tumors and non-neoplastic lesions, ischemia, extra-axial neoplasm and metastasis; the preoperative planning, estimating the tumor grade, guiding the biopsy, resection, local ablative therapy and therapeutic follow-up; the monitoring of disease progression and therapeutic response, including the differentiation of recurrent tumor from delayed radiation necrosis. Imaging plays an integral role in intracranial tumor management. In particular, conventional magnetic resonance imaging (cMRI) has emerged as the imaging modality most frequently used to evaluate intracranial tumors offering important anatomic informations even though sometimes these anatomic informations are not exhaustive in the correct assessment of these tumors. In this review, we are going to investigate the role of the most widely available and practical techniques such as diffusion-weighted imaging (DWI), perfusion-weighted imaging MRI (PMR), diffusion-tensor imaging (DTI), and MR spectroscopy (MRS).