Imaging in Neuro-oncology

Brain tumors are a diverse group of neoplasms that vary widely in treatment and prognosis. Imaging serves as the cornerstone of diagnosis, monitoring response to treatment and identifying progression of disease in neuro-oncologic care. This review outlines current and emerging imaging modalities with a focus on clinical application in glioma, meningioma, and brain metastasis. We cover standard imaging modalities, advanced magnetic resonance techniques such as perfusion and spectroscopic imaging, and nuclear imaging with positron emission tomography (PET), including amino acid PET. We summarize the standardized Response Assessment in Neuro-Oncology (RANO) criteria, and explore innovations in radiomics, artificial intelligence, and targeted imaging biomarkers. Finally, we address challenges related to equitable access to advanced imaging. This review provides a practical, clinically focused guide to support neurologists in the imaging-based care of patients with primary or metastatic brain tumors.