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Glioblastoma
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Grade 4 astrocytoma, malignant astrocytoma, glioblastoma multiforme (outdated term)
            • Definitions

              • Rapidly enlarging, malignant astrocytic tumor characterized by necrosis & neovascularity

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Angiographic Findings

                    • Nuclear Medicine Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Espiritu AI et al: Congenital glioblastoma multiforme with long-term childhood survival: a case report and systematic review. World Neurosurg. 139:90-6, 2020
                                              2. Hakar MH et al: Updates in pediatric glioma pathology. Surg Pathol Clin. 13(4):801-16, 2020
                                              3. Wang Q et al: Primary cerebellar glioblastomas in children: clinical presentation and management. Neurosurg Rev. 44(3):1747-54, 2020
                                              4. Tixier F et al: Preoperative MRI-radiomics features improve prediction of survival in glioblastoma patients over MGMT methylation status alone. Oncotarget. 10(6):660-72, 2019
                                              5. Hong EK et al: Radiogenomics correlation between MR imaging features and major genetic profiles in glioblastoma. Eur Radiol. 28(10):4350-61, 2018
                                              6. Lam S et al: Patient and treatment factors associated with survival among pediatric glioblastoma patients: a surveillance, epidemiology, and end results study. J Clin Neurosci. 47:285-93, 2018
                                              7. Korshunov A et al: H3-/IDH-wild type pediatric glioblastoma is comprised of molecularly and prognostically distinct subtypes with associated oncogenic drivers. Acta Neuropathol. 134(3):507-16, 2017
                                              8. Liu X et al: The preliminary radiogenomics association between MR perfusion imaging parameters and genomic biomarkers, and their predictive performance of overall survival in patients with glioblastoma. J Neurooncol. 135(3):553-60, 2017
                                              9. Cui Y et al: Prognostic imaging biomarkers in glioblastoma: development and independent validation on the basis of multiregion and quantitative analysis of MR images. Radiology. 278(2):546-53, 2016
                                              10. Louis DN et al: The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 131(6):803-20, 2016
                                              11. Nikitović M et al: Pediatric glioblastoma: a single institution experience. Childs Nerv Syst. 32(1):97-103, 2016
                                              12. Andre JB et al: Cerebral blood flow changes in glioblastoma patients undergoing bevacizumab treatment are seen in both tumor and normal brain. Neuroradiol J. 28(2):112-9, 2015
                                              13. Bauer AH et al: Differentiation of solitary brain metastasis from glioblastoma multiforme: a predictive multiparametric approach using combined MR diffusion and perfusion. Neuroradiology. 57(7):697-703, 2015
                                              14. Blasel S et al: Perfusion MRI in the evaluation of suspected glioblastoma recurrence. J Neuroimaging. 26(1):116-23, 2015
                                              15. Harris RJ et al: MRI perfusion measurements calculated using advanced deconvolution techniques predict survival in recurrent glioblastoma treated with bevacizumab. J Neurooncol. 122(3):497-505, 2015
                                              16. Iagaru A et al: Glioblastoma multiforme recurrence: an exploratory study of 18F FPPRGD2 PET/CT. Radiology. 141550, 2015
                                              17. Ideguchi M et al: MRI findings and pathological features in early-stage glioblastoma. J Neurooncol. 123(2):289-97, 2015
                                              18. Kobayashi K et al: Prognostic value of volume-based measurements on (11)C-methionine PET in glioma patients. Eur J Nucl Med Mol Imaging. 42(7):1071-80, 2015
                                              19. Mabray MC et al: Modern brain tumor imaging. Brain Tumor Res Treat. 3(1):8-23, 2015
                                              20. Melguizo-Gavilanes I et al: Characterization of pseudoprogression in patients with glioblastoma: is histology the gold standard? J Neurooncol. 123(1):141-50, 2015
                                              21. Pope WB: Genomics of brain tumor imaging. Neuroimaging Clin N Am. 25(1):105-19, 2015
                                              22. Schmainda KM et al: Dynamic susceptibility contrast MRI measures of relative cerebral blood volume as a prognostic marker for overall survival in recurrent glioblastoma: results from the ACRIN 6677/RTOG 0625 multicenter trial. Neuro Oncol. 17(8):1145-56, 2015
                                              23. Smith TR et al: Use of preoperative FLAIR MRI and ependymal proximity of tumor enhancement as surrogate markers of brain tumor origin. J Clin Neurosci. 22(9):1397-402, 2015
                                              24. Stadlbauer A et al: Quantification of serial changes in cerebral blood volume and metabolism in patients with recurrent glioblastoma undergoing antiangiogenic therapy. Eur J Radiol. 84(6):1128-36, 2015
                                              25. Tietze A et al: Perfusion MRI derived indices of microvascular shunting and flow control correlate with tumor grade and outcome in patients with cerebral glioma. PLoS One. 10(4):e0123044, 2015
                                              26. Barajas RF Jr et al: Benefits of dynamic susceptibility-weighted contrast-enhanced perfusion MRI for glioma diagnosis and therapy. CNS Oncol. 3(6):407-19, 2014
                                              27. Das KK et al: Pediatric glioblastoma: clinico-radiological profile and factors affecting the outcome. Childs Nerv Syst. 28(12):2055-62, 2012
                                              28. Mahvash M et al: Glioblastoma multiforme in children: report of 13 cases and review of the literature. Pediatr Neurol. 45(3):178-80, 2011
                                              29. Perkins SM et al: Glioblastoma in children: a single-institution experience. Int J Radiat Oncol Biol Phys. 80(4):1117-21, 2011
                                              30. Martin V et al: Encountering and advancing through antiangiogenesis therapy for gliomas. Curr Pharm Des. 15(4):353-64, 2009
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Synonyms

                                                          • Grade 4 astrocytoma, malignant astrocytoma, glioblastoma multiforme (outdated term)
                                                        • Definitions

                                                          • Rapidly enlarging, malignant astrocytic tumor characterized by necrosis & neovascularity

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Angiographic Findings

                                                                • Nuclear Medicine Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Espiritu AI et al: Congenital glioblastoma multiforme with long-term childhood survival: a case report and systematic review. World Neurosurg. 139:90-6, 2020
                                                                                          2. Hakar MH et al: Updates in pediatric glioma pathology. Surg Pathol Clin. 13(4):801-16, 2020
                                                                                          3. Wang Q et al: Primary cerebellar glioblastomas in children: clinical presentation and management. Neurosurg Rev. 44(3):1747-54, 2020
                                                                                          4. Tixier F et al: Preoperative MRI-radiomics features improve prediction of survival in glioblastoma patients over MGMT methylation status alone. Oncotarget. 10(6):660-72, 2019
                                                                                          5. Hong EK et al: Radiogenomics correlation between MR imaging features and major genetic profiles in glioblastoma. Eur Radiol. 28(10):4350-61, 2018
                                                                                          6. Lam S et al: Patient and treatment factors associated with survival among pediatric glioblastoma patients: a surveillance, epidemiology, and end results study. J Clin Neurosci. 47:285-93, 2018
                                                                                          7. Korshunov A et al: H3-/IDH-wild type pediatric glioblastoma is comprised of molecularly and prognostically distinct subtypes with associated oncogenic drivers. Acta Neuropathol. 134(3):507-16, 2017
                                                                                          8. Liu X et al: The preliminary radiogenomics association between MR perfusion imaging parameters and genomic biomarkers, and their predictive performance of overall survival in patients with glioblastoma. J Neurooncol. 135(3):553-60, 2017
                                                                                          9. Cui Y et al: Prognostic imaging biomarkers in glioblastoma: development and independent validation on the basis of multiregion and quantitative analysis of MR images. Radiology. 278(2):546-53, 2016
                                                                                          10. Louis DN et al: The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 131(6):803-20, 2016
                                                                                          11. Nikitović M et al: Pediatric glioblastoma: a single institution experience. Childs Nerv Syst. 32(1):97-103, 2016
                                                                                          12. Andre JB et al: Cerebral blood flow changes in glioblastoma patients undergoing bevacizumab treatment are seen in both tumor and normal brain. Neuroradiol J. 28(2):112-9, 2015
                                                                                          13. Bauer AH et al: Differentiation of solitary brain metastasis from glioblastoma multiforme: a predictive multiparametric approach using combined MR diffusion and perfusion. Neuroradiology. 57(7):697-703, 2015
                                                                                          14. Blasel S et al: Perfusion MRI in the evaluation of suspected glioblastoma recurrence. J Neuroimaging. 26(1):116-23, 2015
                                                                                          15. Harris RJ et al: MRI perfusion measurements calculated using advanced deconvolution techniques predict survival in recurrent glioblastoma treated with bevacizumab. J Neurooncol. 122(3):497-505, 2015
                                                                                          16. Iagaru A et al: Glioblastoma multiforme recurrence: an exploratory study of 18F FPPRGD2 PET/CT. Radiology. 141550, 2015
                                                                                          17. Ideguchi M et al: MRI findings and pathological features in early-stage glioblastoma. J Neurooncol. 123(2):289-97, 2015
                                                                                          18. Kobayashi K et al: Prognostic value of volume-based measurements on (11)C-methionine PET in glioma patients. Eur J Nucl Med Mol Imaging. 42(7):1071-80, 2015
                                                                                          19. Mabray MC et al: Modern brain tumor imaging. Brain Tumor Res Treat. 3(1):8-23, 2015
                                                                                          20. Melguizo-Gavilanes I et al: Characterization of pseudoprogression in patients with glioblastoma: is histology the gold standard? J Neurooncol. 123(1):141-50, 2015
                                                                                          21. Pope WB: Genomics of brain tumor imaging. Neuroimaging Clin N Am. 25(1):105-19, 2015
                                                                                          22. Schmainda KM et al: Dynamic susceptibility contrast MRI measures of relative cerebral blood volume as a prognostic marker for overall survival in recurrent glioblastoma: results from the ACRIN 6677/RTOG 0625 multicenter trial. Neuro Oncol. 17(8):1145-56, 2015
                                                                                          23. Smith TR et al: Use of preoperative FLAIR MRI and ependymal proximity of tumor enhancement as surrogate markers of brain tumor origin. J Clin Neurosci. 22(9):1397-402, 2015
                                                                                          24. Stadlbauer A et al: Quantification of serial changes in cerebral blood volume and metabolism in patients with recurrent glioblastoma undergoing antiangiogenic therapy. Eur J Radiol. 84(6):1128-36, 2015
                                                                                          25. Tietze A et al: Perfusion MRI derived indices of microvascular shunting and flow control correlate with tumor grade and outcome in patients with cerebral glioma. PLoS One. 10(4):e0123044, 2015
                                                                                          26. Barajas RF Jr et al: Benefits of dynamic susceptibility-weighted contrast-enhanced perfusion MRI for glioma diagnosis and therapy. CNS Oncol. 3(6):407-19, 2014
                                                                                          27. Das KK et al: Pediatric glioblastoma: clinico-radiological profile and factors affecting the outcome. Childs Nerv Syst. 28(12):2055-62, 2012
                                                                                          28. Mahvash M et al: Glioblastoma multiforme in children: report of 13 cases and review of the literature. Pediatr Neurol. 45(3):178-80, 2011
                                                                                          29. Perkins SM et al: Glioblastoma in children: a single-institution experience. Int J Radiat Oncol Biol Phys. 80(4):1117-21, 2011
                                                                                          30. Martin V et al: Encountering and advancing through antiangiogenesis therapy for gliomas. Curr Pharm Des. 15(4):353-64, 2009