Neuroimaging plays a pivotal role in the clinical practice of brain tumors aiding in the diagnosis, genotype prediction, preoperative planning, and prognostication. Brain metastases are the most common central nervous system (CNS) tumor. The most common primary tumors are lung cancer, breast cancer, and melanoma.

The primary brain tumors most commonly seen in adults are extra-axial lesions like Meningioma and lesions of the pituitary gland or CP angel tumors such as schwanommas .Intra-axial lesions like Glioma are also important differential diagnosis . Clinical features may be localizing like partial seizures, weakness, and sensory disturbances or nonspecific like a headache. On clinical suspicion of a brain tumor, the primary investigative workup should focus on imaging. The magnetic resonance (MR) imaging protocol needs to be standardized and includes conventional sequenceslikeT1-weighted(T1W) imaging with and without contrast, T2w imaging, fluid-attenuated axial inversion recovery, diffusion weighted imaging (DWI), susceptibility-weighted imaging,and advanced imaging sequences like MR perfusion and MR spectroscopy. Multidisciplinary co-ordination is needed for proper management and care of brain tumor patients. Imaging plays a vital role in post-treatment follow-up. Sequences like DWI, MR perfusion, and MR spectroscopy are useful in distinguishing post-treatment effects like radiation necrosis and pseudo-progression from true recurrence.

Case No 1

The patient is 75 year woman with as known case of Adenocarcinoma of the descending colon with several variable-sized enhancing brain metastasis.