| 1p19q |
A chromosome. If the chromosome 1p19q is showing deletion from an oligodendroglioma it means that the tumour is more responsive to chemotherapy. |
| Adjuvant |
Usually used as ‘adjuvant therapies’. These are treatments which are given after a primary treatment, e.g. after removal of a brain tumour |
| Alkylating agents |
A family of anticancer drugs that interfere with a cell’s DNA to stop it growing |
| Anaplastic |
When cells divide rapidly and bear little or no resemblance to normal cells in appearance or function. |
| Anterior |
The front of a structure, or a structure found toward the front of the body. |
| Anti-angiogenic therapy |
Treatment which blocks the formation of new blood vessels around a tumour |
| Antibody |
An antibody is a protein made by the white blood cells to combat foreign substances |
| Antigens |
Any substance capable of inducing a specific immune response and of reacting with the products of that response |
| Artifact |
Fuzziness or distortion in an image caused by manipulation, such as file compression |
| Astrocytes |
A large, star-shaped cell that forms a supportive network for brain tumour tissue |
| Asymptomatic |
If you are asymptomatic it means you don’t have any symptoms |
| Avastin (Bevacizumab) |
A monoclonal antibody that interferes with the blood supply to a brain tumour. It blocks the formation of new blood vessels |
| Awake craniotomy |
Neurosurgery done with the patient awake for all or part of the surgery |
| Axial |
Perpendicular to the long axis of the body |
| Axial (intra and extra) |
Axial is the position as it relates to the central nervous system (CNS). Intra-axial is within the CNS; extra-axial is outside the CNS |
| Benign |
Usually slow growing, less tendency to invade and often curable if completely removed |
| Biopsy |
A medical test performed by a surgeon or an interventional radiologist who will take a sample of cells or tissues for examination |
| Biopsy only |
A surgical procedure to remove a small piece of tumour for examination to make a diagnosis. This is not performed as part of the surgery to remove the tumour but is a separate procedure |
| Blood brain barrier (BBB) |
A barrier between brain tissue and circulating blood. It is there to protect the brain and prevents substances from leaving the blood and crossing into the brain tissues |
| Brain shift |
Deformation and shift of brain tissue during neurosurgery |
| Brain stem |
The bottom portion of the brain, which connects the cerebrum to the spinal chord |
| Burr hole |
A hole made in the skull by a special drill with a rounded tip |
| Calcification |
Deposits of calcium in the tissues |
| Cannula |
A thin tube inserted into a vein or body cavity to administer medicine, drain off fluid, or insert a surgical instrument |
| Carmustine (BCNU) |
A chemotherapy agent used to treat brain tumours |
| Caudal |
Postioned underneath or toward the bottom. Sometimes referred to as inferior |
| Cell |
The basic structural and functional unit in people and all living things. Each cell is a small container of chemicals and water wrapped in a membrane. |
| Cellular packing density |
A large collection of non-overlapping solid objects (particles) is called a packing. They are useful models for the structures of brain tumours. The packing density is defined as the fraction of space covered by the particles. This can be used to model the growth of a brain tumour. |
| Cerebellum |
The second largest structure of the brain, the cerebellum is located just above the neck in the back of the head |
| Cerebrum |
The largest area of the brain, which occupies the uppermost part of the skull. It consists of two halves (hemispheres) |
| cGy (centiGrays) |
A unit of absorbed radiation dose equal to one hundredth |
| Chemosensitive |
The susceptibility of tumour cells to the cell-killing effects of anticancer drugs |
| Chemotherapy |
Drug therapy for cancer |
| Chromatin |
The protein structures that package DNA and regulate its function, in cancer stem cells |
| Chromosome |
Part of a cell that contains genetic information |
| Clinical presentation |
The picture of signs and symptoms, which leads to a diagnosis |
| Coarse |
Thick, rough appearance. This can be used to describe the abnormal chromatin in tumour nuclei |
| Concomitant |
Happening at the same time e.g. concomitant temodal with radiotherapy |
| Concurrent |
Happening at the same time. Radiotherapy and chemotherapy are often referred to as concurrent when they are given at the same time. |
| Conformal |
Radiotherapy beams are shaped in three dimensions to match the shape of the tumour |
| Contrast |
1) The degree to which light and dark areas of an image differ in brightness or in optical density.
2) A contrast agent is a substance injected into the body that illuminates certain structures that would otherwise be hard to see on the radiograph (film). |
| Coronal plane |
The plane of the body that divides front from back. |
| Corpus Callosum |
Nerve fibres that pass through and connect the two halves of cerebral hemispheres |
| Cortex |
The outer layer of the brain |
| Cortical mapping |
Cortical maps identify the language, motor, and sensory areas of the cortex and are often used during brain surgery |
| Craniocaudal |
The direction of entry of the x-ray beam. The beam enters at the cranial end of the part being examined and exits at the caudal end |
| Cranium |
The top portion of the skull |
| CSF (cerebrospinal fluid) |
A watery fluid that is continuously produced and absorbed and that flows in the ventricles within the brain and around the surface of the brain and spinal cord |
| CT (computerised tomography) |
X rays are aimed at slices of the body (by rotating equipment) and the results are assembled with a computer to give a three-dimensional picture of a structure |
| Cyberknife® |
Brand name of a machine used to deliver linear accelerator stereotactic radiosurgery |
| Cyst |
A cyst in the brain is a sphere filled with fluid, similar to a miniature balloon filled with water. Cysts may contain fluid, blood, minerals, or tissue. |
| Cystic |
A cyst in the brain is a sphere filled with fluid, similar to a miniature balloon filled with water. Cysts may contain fluid, blood, minerals, or tissue. If a tumour has cystic components then it may contain some of these things. |
| Cytoplasm |
The fluid inside a cell but outside the cell’s nucleus. Most chemical reactions in a cell take place in the cytoplasm. |
| Cytostatic |
An agent that stops cell growth or division |
| Debulking |
A surgical procedure to reduce the size of a brain tumour by removing a portion of it |
| Delineation |
The outline of the tumour. Also used to delineate target volume of tumour for surgery and radiotherapy |
| Demyelination |
Loss of the myelin sheath of a nerve |
| Dexamethasone |
A corticosteroid drug used to treat inflammation |
| Diffuse |
Widely spread; not confined or localised |
| Dis-cohesive |
Cells that do not stick to each other |
| Dose |
The total amount of ionizing radiation absorbed by material or tissues, expressed in centigrays |
| Dose rate |
The quantity of a treatment given over a period of time |
| DTI (diffusion tensor imaging) |
A refinement of magnetic resonance imaging (MRI) that allows the doctor to measure the flow of water and track the pathways of white matter in the brain. DTI is able to detect abnormalities in the brain that do not show up on standard MRI scans. |
| Dura |
The outermost of the three meninges |
| EEG (electroencephalogram) |
A record of the tiny electrical impulses produced by the brain’s activity. By measuring characteristic wave patterns, the EEG can help diagnose certain conditions of the brain. |
| Eloquent |
Used to describe an area of the brain that is essential for basic neurological functions. Damage to these areas may result in the loss of sensory processing or linguistic ability. |
| End of life |
A phrase used to describe a phase of illness which has become advanced, progressive and incurable |
| Endocrine system |
The tissues or glands in the body that secrete hormones |
| Endothelial |
The main type of cell found in the inside lining of blood vessels in the brain |
| Enhancement |
A substance is used to enhance the structures within the brain during a scan. This reduces the lowest grey values to black and the highest to white. |
| Eosinophilic |
Staining a cell or tissue with the pink dye eosin. This is characteristic of many of the low grade glial tumours. |
| Ependymal |
A cell that forms the lining of the fluid-filled spaces in the brain and spinal cord. It is a type of glial cell. |
| Excision |
A cut |
| External Beam |
Radiation therapy that uses a machine to aim x rays at a brain tumour |
| Fibrillary |
Made up of minute fibres |
| First line management |
Initial treatment of an illness |
| FLAIR (Fluid attenuated inversion recovery) |
A pulse sequence used in scanning to null signal from fluids. For example, it can be used in brain imaging to suppress cerebrospinal fluid (CSF). |
| fMRI (functional MRI) |
Functional MRI takes the map obtained with traditional MRI imaging, and adds on additional dimensions, such as measuring regional blood flow over time, or something about the biochemistry of tissue of a brain tumour in a specified location in the brain |
| Focal |
Limited to a specific area |
| Foci |
Foci is the plural of focus.It suggests microscopic visualisation of the tumor cells. Under a microscope therefore you might see more than one indication of one or two microscopic foci of possible invasion. |
| Fractionated |
Dividing the total dose of radiation to be given into several smaller, equal portions delivered over a period of days |
| Gadolinium |
A substance that enhances tumour images using magnetic resonance imaging (MRI). |
| Gamma Knife ® |
Brand name of a machine used to deliver stereotactic radiosurgery (SRS), a focal form of radiation therapy |
| GFAP |
Short for Glial Fabrillary Acidic Protein. This is a gene. It provides instructions for making GFAP protein, a member of the family that provides support and strength to cells. |
| Gliadel ® |
The brand name of a wafer used to deliver chemotherapy |
| Glial cells |
Any of the cells that hold nerve cells in place and help them work the way they should. The types of glial cells include oligodendrocytes, astrocytes, microglia, and ependymal cells. Also called neuroglia. |
| Gliolan/5 ALA ® |
Gliolan is a powder to be made up into a solution to be taken by mouth. Gliolan is used in adult patients with malignant glioma. It helps surgeons to see the tumour more clearly during an operation to remove it from the brain |
| Global |
Throughout the brain |
| Grade |
A brain tumour will be given a grade which refers to the way the cells of the tumour look under a microscope. Grade 1 (low grade) refers to tumours that appear less likely to spread and grade IV (high grade) refer to tumours that appear to grow more quickly, or are most malignant. The brain tumour will be graded according to the highest grade of cell that the pathologist sees in the biopsy specimen. So if the tumour has a high percentage of grade II cells, and a small percentage of grade III cells, the tumour will be graded as a grade III. |
| Gross total resection |
Removal of all the tumour |
| Halo |
An area of perinuclear clearing |
| Heterogeneity |
A state of having different characteristics and qualities |
| Heterogeneous |
A state of having different characteristics and qualities |
| High grade |
Tumours that appear to grow more quickly, or are most malignant |
| Histology |
The study of tumour cells under a microscope |
| Histopathology |
The study of diseased tissues at a minute (microscopic) level |
| Homogeneous |
Of a uniform, consistent nature |
| Hydrocephalus |
An abnormal buildup of cerebrospinal fluid (CSF) in the ventricles of the brain |
| Hyperchromatic |
Abnormally highly coloured or excessively stained |
| Hyperostosis |
An excessive growth of bone |
| Hypothalamus |
The region of the brain that forms part of the wall of the third ventricle. It is part of the endocrine system. |
| IDH-1 |
Short for Isocitrate Dehydrogenase. IDH is an enzyme, one form of which participates in the citric acid cycle |
| Image guidance |
A surgical procedure where the surgeon uses tracked surgical instruments to indirectly guide the procedure |
| Imaging |
The use of technology to create a picture of the brain e.g. MRI scan |
| Immunocytochemistry |
Technique which uses specific antibodies to identify and stain tissue |
| Immunohistochemistry (IHC) |
The process of detecting antigens or biological markers within tumours or brain tissue using antibodies. Immunohistochemistry provides insight about the classification of brain tumours by identifying cellular markers of phenotype and about the tumour’s potential to grow. |
| Immunoreactive |
Reacts with an antibody |
| iMRI |
A form of MRI called intraoperative magnetic resonance imaging. It is used to see brain tumours clearly while performing surgery. |
| IMRT (intensity modulated radiation therapy) |
Specialised equipment that shapes radiation beams to the size and shape of the tumour |
| Increased (high) signal |
Hyperintensity signals show up as increased brightness (white) on MRI using different scanning techniques. The nature of brain scans causes tissues with more water to give off brighter signals that appear whiter on the scans. |
| Inflammation |
Swollen brain tissue |
| Infra-tentorial |
Below the tentorium |
| Intracranial |
Inside the cranium |
| Intracranial haemorrhage |
Bleeding within the skull |
| Intracranial pressure (ICP) |
Pressure inside the cranium |
| Intravenous |
Into the vein |
| Intrinsic |
Originating from, or situated within, an organ or tissue |
| Isotope |
A form of a chemical element that has a different-from-normal atomic mass. Isotopes are used in a number of medical tests because they can produce images of tissues that can be used to detect diseases or conditions. |
| Ki67 |
An antigen that detects cells in synthesis phase (the period when the chromosomes are replicated). |
| Late effects |
A health problem that occurs months or years after a disease is diagnosed or after treatment has ended |
| Laterality |
The side of the body in which symptoms are showing |
| Lesion |
A brain lesion describes damage or destruction to any part of the brain. It may be due to trauma or any other disease that can cause inflammation, malfunction, or destruction of a brain cells or brain tissue |
| Leukopenia |
A reduction in the number of white cells in the blood |
| LINAC (linear accelerator) |
An electrical device that creates ionising radiation in the form of x-rays (photons) |
| Lobe |
One of four sections of the cerebral hemispheres |
| Localised |
Confined or restricted to an area |
| Lomustine (CCNU) |
A chemotherapy agent used to treat brain tumours |
| Low grade |
Tumours that appear less likely to spread |
| Macroscopy |
Examination with the naked eye |
| Malignant |
Cancerous, tending to invade normal tissue or to recur after removal |
| Margin |
A border or edge of the tumour |
| Markers |
Pathologists can test for markers in the tumour tissue. Markers can be genetic, molecular or immunohistochemistry. These tests can: |
| Mask |
A mould to keep your head from moving so that you are in the exact same position for each treatment |
| MDT |
Multidisciplinary team meeting |
| Median survival |
Average survival time for patients with a certain tumour. 50% will survive longer than the median survival and 50% will survive less. |
| Meninges |
A membrane (one of 3) that envelops the brain and spinal cord) |
| Metabolism |
The chemical and physical processes that happen to maintain the body and produce energy |
| Metastasis/metastases |
Spread to another part of the body, usually through blood vessels, lymph channels or spinal fluid. |
| Metastatic brain tumour |
A secondary brain tumour formed of cancer cells that began elsewhere in the body e.g. lung, breast, colon, kidney, skin |
| MGMT |
Abbreviation for 06-methylguanine –DNA methyltransferase, a gene thought to play a role in DNA repair |
| MIB1 |
A gene that regulates cell death (apoptosis) |
| Micro-calcification |
A tiny abnormal deposit of calcium salts |
| Microvascular proliferation |
Abnormally thickened blood vessels which tend to be seen in higher grade gliomas. They tend to be leaky and cause contrast enhancement on imaging |
| Midline |
An imaginary line running along the surface of the brain (front to back), which separates the right and left hemispheres |
| Mitoses |
The number of cells dividing |
| Modality |
A method of treatment |
| Molecular analysis |
The analysis of human DNA, RNA, and chromosomes to establish a diagnosis or prognosis |
| Monoclonal |
Deriving from a single cell |
| Morphology |
The form and structure e.g. of a tumour |
| Motor |
Movement, control of muscles |
| MRI (magnetic resonance imaging) |
A special radiology technique which takes pictures of internal structures of the body using magnetism, radio waves, and a computer to produce the images of body structures |
| Multifocal |
Having many focal points. Damage caused by the disease occurs at multiple sites |
| Multinucleated |
Having more than one nucleus per cell |
| Myelin sheath |
The insulating envelope of myelin that surrounds the core of a nerve fibre. It facilitates the transmission of nerve impulses. |
| Myelosuppression |
A decline or absence of blood cell production |
| Necrosis |
Dead cells in tissue |
| Neoplasm |
A tumour, either benign or malignant |
| Neoplastic |
Used to describe abnormal new growth of tissue |
| Neuro-oncology |
The branch of medical science dealing with tumours of the nervous system |
| Neuroendoscope |
An endoscope for examining and performing various interventions in the central nervous system |
| Neuroendoscopy |
The use of a neuroendoscope with the aid of a neuronavigation system to examine the central nervous system and perform minimally invasive neurosurgical procedures. |
| Neurofibrillary matrix |
Extracellular background in which the cell sits |
| Neuronavigation |
Pre-operative MRI information, fed into a computer, that allows the surgeon to view 3D images during surgery |
| Neuropathology |
The study of diseases of the nervous system, which includes the brain |
| Neurotoxicity |
Damage to the nervous system |
| Neutropenia |
An abnormal decrease in the number of neutrophils, a type of white blood cells |
| Nitrosureas |
A group of anticancer drugs able to cross the blood brain barrier |
| Nuclear |
Forming a nucleus |
| Nucleus |
The structure in a cell that contains the chromosomes |
| Occipital lobe |
The lobe of the cerebral hemispheres at the back of the head, just above the neck |
| Oedema |
Swelling caused by fluid |
| Oligodendrocytes |
Cells that cover and protect nerve cells in the brain and spinal cord |
| Oligodendroglial |
Describes a slow-growing tumor that begins in oligodendrocytes. |
| Optimal |
Most desirable or satisfactory |
| Oral |
By mouth |
| Overall survival (OS) |
The percentage of people in a study or treatment group who are still alive for a certain period of time after they were diagnosed with or started treatment for a disease |
| Palisading |
The lining up of cells which gives them the ordered appearance of a fence |
| Palliative |
Therapy with the goal of relieving symptoms and improving quality of life |
| Palliative radiation |
Radiation therapy with a goal of relieving symptoms and improving quality of life |
| Paraffin |
Used in tissue preparation and processing |
| Parietal lobe |
The lobe of the cerebral hemispheres at the upper back area of the head. |
| Partial |
Not total. Some tumour could not be removed |
| Pathology |
The branch of medicine that looks at abnormal changes in cells and tissues which signal disease |
| PCV regimen (procarbazine, lomustine (CCNU), vincristine) |
A combination chemotherapy regimen |
| Perfusion MR |
A special type of MRI that uses an injected dye in order to see blood flow through tissues |
| Perinuclear |
Situated around a nucleus |
| PET (position emission topography) |
A scanning device which uses low dose radioactive sugar to measure brain activity |
| Pleomorphic |
Varying in cell shape |
| Posterior |
The back of a structure, or a structure found toward the back of the body. |
| Prognosis |
A forecast as to likely outcome, the chance of recovery |
| Progression free survival (PFS) |
The length of time during and after the treatment of a disease that a patient lives with the disease but it does not get worse. |
| Proliferation |
The growth and reproduction of similar cells. |
| Prophylaxis |
Preventative |
| Proton beam |
A treatment that uses high energy beams to treat tumours |
| Pseudoprogression |
Swelling or contrast enhancement on a scan which suggests tumour progression or recurrence, when it is treatment effect. Pseudoprogression can stabilise without additional treatments and often remains clinically asymptomatic |
| R132H |
The most common point mutation of IDH1.This mutation is more commonly seen in lower grade gliomas and the higher grade gliomas that derive from them |
| Radiation oncology |
The use of radioactive substances and x-rays for the treatment of brain tumours |
| Radiosurgery |
A special form of radiation therapy that uses a large number of narrow, precisely aimed, high dose beams of ionising radiation |
| Radiotherapy |
A treatment in which high-energy rays are used to damage cancer cells and stop them from growing and dividing |
| Regime |
A regulated system of treatment |
| Resection |
Surgical removal of a brain tumour |
| Saggital plane |
The plane of the body that divides right from left. |
| Segmental |
Made up of segments |
| Shunt |
A drainage system inserted in the brain to drain fluid from a ventricle into a body cavity |
| Signal |
Brightness of a tissue or structure on MRI |
| Single agents |
Treatment with a single chemotherapy agent; i.e., treatment with one type of chemotherapy drug, rather than with a combination of different chemotherapy drugs |
| Sonowand ® |
Technology which enables the surgeon to update the map during surgery, scanning the brain with real time 3D ultrasound. |
| Specimen |
A sample of tissue, blood, or urine which is used for analysis and diagnosis |
| SPECT (single photon emission computed tomography) |
A scanning technique which uses radioactive materials |
| Stereotactic |
Precise positioning in a 3D space |
| Stereotactic biopsy |
A biopsy accomplished with a computer guided needle |
| Stereotactic radiosurgery (SRS) |
A form of radiation therapy that focuses high-powered x-rays on a small area of the body, better targeting the abnormal area. It is a treatment, not a surgical procedure. Some types of stereotactic radiosurgery require a specially fitted face mask or a frame attached to your scalp |
| Steroid |
Medication used to reduce swelling and inflammation around a brain tumour |
| Sub-total resection |
Less than total surgical removal of a tumour |
| Subcortical |
The region of the brain below the cortex |
| Supra-tentorial |
Above the tentorium |
| Suture |
A stitch |
| Systemic |
Affecting or circulating throughout the body |
| T1 weighting |
MRI image showing structures; cerebrospinal fluid appears black on the image |
| T2 weighting |
MRI image showing water; oedema and cerebrospinal fluid appear white on the image |
| Temozolomide (TMZ) |
An anti cancer drug that belongs to the family of drugs called alkylating agents |
| Temporal lobe |
The lobe of the cerebral hemispheres that sits behind the ears. |
| Tentorium |
A flap of the meninges separating the cerebral hemispheres from the brain structures |
| Thalamus |
The area surrounding the third ventricle. Its primary function is to relay sensory information. |
| Thrombocytopenia |
A decrease in the normal number of platelets in the blood |
| Tissue |
A group or layer of cells that work together to perform a specific function |
| Toxicity |
State of being poisonous |
| Trajectory |
A chosen course |
| Tumour progression |
When a tumour recurs, or begins to grow again. The second stage of tumour development |
| Vascular |
Relating to the blood vessels of the body |
| Vascularity |
The blood supply of a tumour |
| Ventricles |
Four connected cavities in the brain through which cerebrospinal fluid flows |
| WBRT (whole brain radiotherapy) |
A type of external beam radiotherapy which is given to the whole brain over a period of weeks. |
| WHO classification |
The World Health Organisation (WHO) classification for the grading of brain tumours
– aid the diagnosis of brain tumours which are sometimes hard to diagnose
– allow clinicians to work out a prognosis
– indicate whether a tumour will respond to a specific type of treatment. |
Date published: 17-05-2009
