The first step in diagnosis for how to know if you have brain cancer is to evaluate the individual's symptoms. If the symptoms show an indication of brain cancer, the tests done to confirm diagnosis include magnetic resonance imaging (MRI) scan, computed axial tomography (CAT or CT) scan, and positron emission tomography (PET) scan.

CAT scans are specialized x-ray tests combined with a computer that takes pictures of the inside of the brain and brain stem, allowing the doctor to look for tumors. The CAT scan differs from standard x-rays in that it utilizes a computer to accomplish a cross-sectional view that allows for a much more accurate look at the soft tissues of body parts like that of the brain. A dye is often injected into the body to improve the contrast between abnormal and healthy tissue. CAT scanners have been in use since the mid 1970s.

MRI scans use magnetic and radio waves to take pictures of the inside of the body. Like the CAT scan, it provides images of the soft tissues of the body allowing the doctor to look for abnormalities. As a tool it will take pictures from any angle which is promoted as an advantage over CAT scans by institutions that use the MRI as the primary method of diagnosis. MRI is a technique that has been in use since the 1980s.

PET scans are not nearly as commonly used by institutions for determining how to know if you have brain cancer. The technique has been in limited use since the 1950s. It requires the injection of a short-lived radioactive isotope into the body, which allows for imaging of the body tissues. It is often combined with CAT scanning for a broad picture.

Skull x-rays were widely used at one time but have generally been replaced by the above scan procedures. Different institutions will use one or another of the scans as the first diagnostic test.
Any tumor located would be followed by a biopsy of the tissue to arrive at an exact diagnosis. A biopsy is a surgical procedure whereby a small portion of the abnormal tissue is removed and sent to a lab where a doctor can then study is under a microscope. The type and characteristics of the cells can then be determined as to whether it is malignant, degree of invasiveness and growth rate.

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