Role of the radionuclide brain image in the diagnosis of brainstem gliomas.

The noninvasive detection of brainstem gliomas remains difficult. Eleven of our patients with proven brainstem gliomas had radionuclide brain imaging prior to the initiation of therapy or confirmation of the diagnosis; six studies were positive. Pneumoencephalography remains the most reliable diagnostic test for brainstem glioma, and is invariably required for confirmation. Although angiography is useful in the evaluation of vasocularity it may not detect small infiltrating lesions. Radionuclide brain imaging is useful in the initial workup of patients with suspected brainstem gliomas.