Genetics of Glioblastoma: A Window Into Its Imaging and Histopathologic Variability

Radiographics. 2011 Oct;31(6):1717-40. doi: 10.1148/rg.316115512.

Abstract

Glioblastoma is a highly malignant brain tumor that relentlessly defies therapy. Efforts over the past decade have begun to tease out the biochemical details that lead to its aggressive behavior and poor prognosis. There is hope that this new understanding will lead to improved treatment strategies for patients with glioblastoma, in the form of targeted, molecularly based therapies that are individualized to specific changes in individual tumors. However, these new therapies have the potential to fundamentally alter the biologic behavior of glioblastoma and, as a result, its imaging appearance. Knowledge about common genetic alterations and the resultant cellular and tissue changes (ie, induced angiogenesis and abnormal cell survival, proliferation, and invasion) in glioblastomas is important as a basis for understanding imaging findings before treatment. It is equally critical that radiologists understand which genetic pathway is targeted by each specific therapeutic agent or class of agents in order to accurately interpret changes in the imaging appearances of treated tumors.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / pharmacology*
  • Animals
  • Antineoplastic Agents / pharmacology*
  • Brain Neoplasms / classification
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / genetics*
  • Brain Neoplasms / pathology
  • Cell Proliferation
  • Cell Survival / genetics
  • Erlotinib Hydrochloride
  • Gefitinib
  • Gene Expression Regulation, Neoplastic
  • Glioblastoma / classification
  • Glioblastoma / drug therapy*
  • Glioblastoma / genetics*
  • Glioblastoma / pathology
  • Humans
  • Magnetic Resonance Imaging*
  • Neoplasm Invasiveness / genetics
  • Neovascularization, Pathologic / drug therapy
  • Neovascularization, Pathologic / genetics
  • Phosphorylcholine / analogs & derivatives
  • Phosphorylcholine / pharmacology
  • Protein Kinase Inhibitors / pharmacology
  • Quinazolines / pharmacology

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Quinazolines
  • Phosphorylcholine
  • perifosine
  • Erlotinib Hydrochloride
  • Gefitinib