Molecular Markers of Glioblastoma and the Potential for Integration with Imaging: the Future for Assigning Prognosis and Best Treatment Strategy
Noelyn A. Hung, Janice A. Royds and Tania L. Slatter
Affiliation: Department of Pathology, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand.
Keywords: Glioblastoma, molecular markers, non-invasive imaging, prognosis, tumor subtypes, telomere maintenance mechanisms.
Glioblastoma is an aggressive form of brain tumor with a poor outcome. Recent advancements using molecular
techniques have identified subtypes of glioblastoma that have emerged from the traditional classification. The molecular
subtypes are associated with different prognoses and responses to treatment. Both features make molecular sub-typing important
in the clinical setting. Detection of each subtype, or key mutations within, currently occurs post-surgically using
histological and biochemical based techniques. Non-invasive imaging, particularly magnetic resonance imaging (MRI), is
an integral part of glioblastoma diagnosis and patient management. Whether non-invasive imaging can identify molecular
subtypes pre-surgically is likely to be true based on recent proof of concept approaches. Correlating molecular subtypes
and imaging features will led to more detailed subtypes, a greater stratification of patients, and assignment of the best
treatment option. This review summaries the current molecular subtypes based on telomere maintenance mechanisms or
genomic approaches, key genetic markers in each tumor subtype, and whether these markers correlate with patient prognosis.
An outline of methods to distinguish tumor subtypes is given including efforts toward detecting molecular changes
by non-invasive imaging.
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