Bye bye biopsy! Chemicals diagnosis cancer

It's believed close to 70,000 Americans will be diagnosed with a cancerous or non-cancerous brain tumor this year. Even if they are removed, there's a chance the tumors could come back.

Now, doctors are using a new way to figure out if a dangerous tumor is regrowing or if something else is going on in the brain.

"I have a tumor the size of a goose egg right here in my head," Mary Grace explains.

After radiation therapy, Mary Grace had that benign tumor removed from her brain. Then, a new mass popped up in the same spot.

Radiologist Doctor Robert Kagan believed it was one of two things.

"The question here was, is this a malignant tumor caused by the radiation or is this an effect of the radiation?" says Dr. Robert L. Kagan, MD, a Radiologist/pathologist at the MRI Scan Center.

Tissue damage caused by radiation and cancerous tumor cells look alike.

"The chemical composition of radiation necrosis is a lot different than a malignant tumor," explains Dr. Kagan.

The doctor was able to determine the chemical make-up of Mary's mass with MR spectroscopy.

Without an invasive biopsy or injecting dye, he uses an advanced MRI machine to figure out if the growth is cancerous.

The ratio of various brain chemicals lead to a diagnosis.

"That shows you that it is necrosis and not a tumor," Dr. Kagan says.

Mary's cancer scare has passed and the benign brain mass is safely removed.

"Now my synapses are firing,” says Mary. “It's like a Gatling gun."

Doctor Kagan has one of about 200 MRI machines capable of performing state-of-the-art MR spectroscopy in the United States.

Others are located at places like Mayo Clinic, Duke University and Stanford University Medical Center.

The test is not covered by insurance at this time and could cost you about $900. The doctor says MR spectroscopy is also being used to detect breast and prostate cancers in clinical trials.


TOPIC: Bye bye biopsy! Chemicals diagnosis cancer
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BACKGROUND: The causes of brain tumors are unknown. There are only a few known risk factors. Children who receive radiation to the head have a greater risk of developing a tumor on the brain when they are adults, as well as people who have rare genetic conditions, like neurofibromatosis or Li-Fraumeni syndrome. These cases only represent a fraction of the 35,000 new primary brain tumors diagnosed every year. Age is another risk factor. People over 65 years are diagnosed with brain cancer at a rate four times higher than younger people. A primary brain tumor originates in the brain and they are not all cancerous. A benign tumor is not aggressive, but can be life-threatening. (Source:

SYMPTOMS: Symptoms vary according to the type of tumor and location. Different ares of the brain control different functions of the body, where the tumor is located will affect the symptoms. Some tumors do not have symptoms. A common symptom is headaches. Others can include: seizures, changes in vision, changes in speech, balance problems, numbness or tingling in the arms or legs, problems with walking, personality changes, problems with memory, weakness in one part of the body, and the inability to concentrate. (Source:

TREATMENT: Surgery to remove the tumor is the typical first option, but some can't be removed because of the location. Chemotherapy and radiation therapy are other options to kill the tumor. They can also be used after the surgery to kill remaining cancer cells. For tumors that are embedded deep in the brain, a form of highly focused radiation therapy can be used to treat it, called Gamma Knife therapy. (Source:

NEW TECHNOLOGY: Even if the tumor is successfully removed, there is always a chance it can come back. Therefore, diagnostic tools are necessary. A new noninvasive diagnostic test for measuring biochemical changes in the brain is called Magnetic Resonance (MR) spectroscopy. Magnetic Resonance Imaging identifies the anatomical location of the tumor; MR spectroscopy compares the chemical composition of normal brain tissue with abnormal tumor tissue. It can also be used to identify tissue changes in epilepsy and stroke. MR spectroscopy is done on the same machine as MRI. It is a series of tests that are added to the MRI scan of the brain or spine to measure the chemical metabolism of a tumor. It analyzes molecules like protons or hydrogen ions. Proton spectroscopy is more common. Several different metabolites can be used to differentiate between tumor types, including: lipid, lactate, amino acids, myoinositol, choline, creatine, and N-acetyl aspartate. The frequency of these metabolites is measured in units called per million (ppm) and plotted on a graph as peaks of height. The neuroradiologist can determine the type of tissue present. It can be used to determine tumor type and aggressiveness, and it can distinguish between radiation necrosis and recurrence. MRI and MR spectroscopy are both safe. There are no health risks associated with the magnetic field or the radio waves used by the machine. (Source: )


Robert Kagan, MD
Medical Director
MRI Scan Center
(954) 772-8000

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