Assessing and monitoring intratumor heterogeneity in glioblastoma: how far has multimodal imaging come?


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Authors
Boonzaier, Natalie R 
Piccirillo, Sara GM 
Price, Stephen J 
Abstract

Glioblastoma demonstrates imaging features of intratumor heterogeneity that result from underlying heterogeneous biological properties. This stems from variations in cellular behavior that result from genetic mutations that either drive, or are driven by, heterogeneous microenvironment conditions. Among all imaging methods available, only T1-weighted contrast-enhancing and T2-weighted fluid-attenuated inversion recovery are used in standard clinical glioblastoma assessment and monitoring. Advanced imaging modalities are still considered emerging techniques as appropriate end points and robust methodologies are missing from clinical trials. Discovering how these images specifically relate to the underlying tumor biology may aid in improving quality of clinical trials and understanding the factors involved in regional responses to treatment, including variable drug uptake and effect of radiotherapy. Upon validation and standardization of emerging MR techniques, providing information based on the underlying tumor biology, these images may allow for clinical decision-making that is tailored to an individual's response to treatment.

Description
Keywords
advanced imaging, glioblastoma, intratumor heterogeneity, subregional assessment, underlying biology, Animals, Brain Neoplasms, Glioblastoma, Humans, Multimodal Imaging
Journal Title
CNS Oncol
Conference Name
Journal ISSN
2045-0907
2045-0915
Volume Title
4
Publisher
Future Medicine Ltd
Sponsorship
National Institute for Health and Care Research (NIHR/CS/009/011)
Stephen Price is funded by a Clinician Scientist Award from the National Institute for Health Research.