For several years, doctors have utilized positron emission tomography (PET) scans to look at nodules and masses to determine whether they are benign or malignant.

This technology is increasingly used and is not only useful in making the initial diagnosis. But once a malignancy is diagnosed, the PET scan can be used to follow the results of the treatment and to look for spread of the disease.

An important factor that has developed in the past few years is a single proton emission CT — also called a SPECT CT — that looks at brain function and not just brain anatomy.

Utilization of the SPECT scan has been useful in helping veterans who were told based on their CT and MRI scans that their symptoms were all psychological, but by doing the SPECT brain scan we could see there were marked abnormalities in the brain function, documenting what years ago was recognized as idling neurons. These are cells that are not doing their normal brain function, but are still living and therefore look normal on the CT and MRI studies.

Another new technique for MRIs is called fusion MRI. This scan can also measure brain function — not just brain anatomy. I have not had the opportunity to work with the fusion MRI, but it sounds very interesting.

Another technology that that is developing MRI spectroscopy, which permits the differentiation between a malignant group of cells and a benign group of cells based on the spectroscopic pattern shown in the cells.

This takes us back to what MRI was originally developed for where it looked at the spectrum of the cells and the advantages is it would eliminate the need of a biopsy and possible spread of the cancer with the biopsy process.