Story by: David Martin Reviewed by Mustafa Barbour, M.D. on January 8, 2024
Our board-certified oncologists use the latest treatment options available to treat childhood brain tumors.
A child who has sudden changes in vision, hearing or speech, or develops balance issues or other symptoms that suggest a possible brain tumor may need to have 3D pictures taken of their brain.
“Based on a child’s symptoms and a clinical evaluation, brain imaging is the next step,” said Mustafa Barbour, M.D., pediatric hematologist/oncologist and neuro-oncologist with Norton Children’s Cancer Institute, affiliated with the UofL School of Medicine.
In certain cases, a CT scan of the head is done first to rule out an emergency that would require immediate surgery. This could be the case if a child has dangerous swelling, fluid buildup or a blood clot in the brain.
A CT scan is a noninvasive imaging procedure that combines multiple X-rays and uses a computer to combine them into detailed 3D images.
If no CT is needed, an MRI will show whether a child has a brain tumor. Like the CT scan, an MRI is noninvasive. It uses a powerful magnet to create highly detailed 3D images that will show even the smallest abnormalities.
If the MRI reveals a tumor, a surgeon typically will either remove the tumor surgically or perform a biopsy to remove a small amount of tissue from the tumor. A sample of the tumor tissue can be examined to determine its details, such as what type it is and how it is likely to grow.
For example, looking at tumor cells under a microscope can show the tumor’s histology, meaning the microscopic structure of the tumor cells. From the histology, a pathologist can classify what general type of brain tumor the child has and determine how aggressive the tissue appears.
Pathologists also will perform tests on the tumor tissue, looking for specific chemical biomarkers on the tumor and analyzing the DNA and RNA. With these tests, the tumor can be categorized into specific subtypes, which can help match the patient with the most effective and least toxic treatment, such as targeted therapy or immunotherapy.
As a member of the Children’s Oncology Group, Norton Children’s Cancer Institute can offer patients methylation profiling data through the National Cancer Institute’s Childhood Cancer Data Initiative/Molecular Characterization Initiative.
Methylation refers to chemical modification to the DNA that signals which parts of the genetic code to copy. This profiling data can give additional information about what treatment might be best for an individual child.
The Children’s Oncology Group includes more than 200 hospitals and institutions sharing information and data to improve treatments and develop new therapies for children with cancer.
“As cancer treatments have involved, more treatments are being developed to disrupt brain cancers by targeting the specific chemical or genetic makeup of a child’s tumor. Sharing data between hospitals and other institutions will speed up the process of finding new and better treatments,” Dr. Barbour said.