Which is Superior in Diagnosing Focal Brain Lesions: CT, MRI, MRS or Histopathology?

Diagnosis is the key for treatment plan. Some fundamental tasks for accurate diagnosis include: (1) Anatomic localization of the lesion and its relation to surrounding structures which could be determined by CT and /or MRI brain. (2) Evaluation of the activity of this lesion (hyperactive, normal, or silent) by magnetic resonance spectroscopy (MRS). (3) Determining cell of origin of the lesion through tissue sampling which is the gold standard for diagnosing the type of cellular elements of the lesions but taking in consideration that partial excision of tumor tissue may change the behavior of the tumor. Other fundamental tasks like the clinical condition either local or general cannot be neglected. When a patient comes for the evaluation of a focal brain lesion, it is often difficult to differentiate between tumoral and non-tumoral brain lesions and frequently creates a dilemma for physicians and surgeons for further management. The current gold standard characterization of a brain tumor is by histopathological analysis [1].