"Of note, a recent proposal by the Consortium to Inform Molecular and Practical Approaches to Central Nervous System Tumour Taxonomy (cIMPACT-NOW) has suggested using caution when assigning CNS WHO Grade 4 (diagnosis of glioblastoma IDH-wildtype) to a 'TERT promoter only', histologically low-grade, IDH-wildtype tumour. Similarly, cIMPACT-NOW has recommended that EGFR gene amplification and +7/-10 chromosome copy number alterations should not be used as solitary defining features for diagnosing high-grade gliomas as glioblastoma, IDH-wildtype in patients < 40 years of age 35. This area is evolving."
"alterations of the CDK4/6–RB1 cell-cycle pathway: 80% due to deletions of CDKN2A 20"
"ADC values are typically similar to normal white matter (745 ± 135 x 10-6 mm2/s 13), but significantly lower than surrounding vasogenic oedema which has facilitated diffusion"
"facilitated diffusion (ADC values >1000 x 10-6 mm2/s)"
"ADC values are typically similar to normal white matter (745 ± 135 x 10-6 mm2/s 13), but significantly lower than surrounding vasogenic oedema which has facilitated diffusion"
"facilitated diffusion (ADC values >1000 x 10-6 mm2/s)"
"MR perfusion: rCBV elevated compared to lower-grade tumours and normal brain"
"More complete surgical resection can be aided by the use of intraoperative MRI and 5-ALA fluorescence-guided surgery 26."
"lower pre-diagnosis functional status (e.g. ECOG performance status)"
"Glioblastoma was previously known as glioblastoma multiforme; the multiforme referred to the tumour heterogeneity. In the revised 4th edition (2016) of the WHO classification, the term "multiforme" was dropped, and these tumours were referred to simply as glioblastomas. In the revised 4th edition, the abbreviation GBM was kept for disambiguation 16, however, it no longer appears in the 5th edition summary 20. Nonetheless, GBM remains widely used in routine clinical practice."
"Glioblastomas had traditionally been divided into primary and secondary; the former arising de novo (90%) and the latter developing from a pre-existing lower-grade tumour (10%)."
"TERT promoter mutation"
"TERT promoter mutations"
"myo-inositol: decreased"
"Genome-wide association studies of genetic risk factors have validated 11 single-nucleotide polymorphisms associated with increased risk for glioblastoma, such as variants in TERT, RTEL1, EGFR, and CDKN2B 34."
"Genome-wide association studies of genetic risk factors have validated 11 single-nucleotide polymorphisms associated with increased risk for glioblastoma, such as variants in TERT, RTEL1, EGFR, and CDKN2B 34."
"Of note, a recent proposal by the Consortium to Inform Molecular and Practical Approaches to Central Nervous System Tumour Taxonomy (cIMPACT-NOW) has suggested using caution when assigning CNS WHO Grade 4 (diagnosis of glioblastoma IDH-wildtype) to a 'TERT promoter only', histologically low-grade, IDH-wildtype tumour. Similarly, cIMPACT-NOW has recommended that EGFR gene amplification and +7/-10 chromosome copy number alterations should not be used as solitary defining features for diagnosing high-grade gliomas as glioblastoma, IDH-wildtype in patients < 40 years of age 35. This area is evolving."
"Of note, a recent proposal by the Consortium to Inform Molecular and Practical Approaches to Central Nervous System Tumour Taxonomy (cIMPACT-NOW) has suggested using caution when assigning CNS WHO Grade 4 (diagnosis of glioblastoma IDH-wildtype) to a 'TERT promoter only', histologically low-grade, IDH-wildtype tumour. Similarly, cIMPACT-NOW has recommended that EGFR gene amplification and +7/-10 chromosome copy number alterations should not be used as solitary defining features for diagnosing high-grade gliomas as glioblastoma, IDH-wildtype in patients < 40 years of age 35. This area is evolving."
"Of note, a recent proposal by the Consortium to Inform Molecular and Practical Approaches to Central Nervous System Tumour Taxonomy (cIMPACT-NOW) has suggested using caution when assigning CNS WHO Grade 4 (diagnosis of glioblastoma IDH-wildtype) to a 'TERT promoter only', histologically low-grade, IDH-wildtype tumour. Similarly, cIMPACT-NOW has recommended that EGFR gene amplification and +7/-10 chromosome copy number alterations should not be used as solitary defining features for diagnosing high-grade gliomas as glioblastoma, IDH-wildtype in patients < 40 years of age 35. This area is evolving."
"Of note, a recent proposal by the Consortium to Inform Molecular and Practical Approaches to Central Nervous System Tumour Taxonomy (cIMPACT-NOW) has suggested using caution when assigning CNS WHO Grade 4 (diagnosis of glioblastoma IDH-wildtype) to a 'TERT promoter only', histologically low-grade, IDH-wildtype tumour. Similarly, cIMPACT-NOW has recommended that EGFR gene amplification and +7/-10 chromosome copy number alterations should not be used as solitary defining features for diagnosing high-grade gliomas as glioblastoma, IDH-wildtype in patients < 40 years of age 35. This area is evolving."
"previously known as glioblastoma with PNET-like component"
"histologically appears similar to oligodendroglioma, but usually demonstrates EGFR amplification"
"GFAP: positive but of variable intensity"
"EGFR: positive in 60% of cases 20"
"GE/SWI"
"NAA: decreased"
"More complete surgical resection can be aided by the use of intraoperative MRI and 5-ALA fluorescence-guided surgery 26."
"lower pre-diagnosis functional status (e.g. ECOG performance status)"
"TERT promoter mutation, more frequent in younger patients and having more frequent PI3K pathway mutations 20,31"
"EGFR amplification 30-32"
"Glioblastomas have been the subject of close trial scrutiny, with many new chemotherapeutic agents showing promise. As such, a number of criteria have been created over the years to assess response to treatment. The response assessment in neuro-oncology (RANO) criteria are most widely used. Other historical systems are worth knowing to allow the interpretation of older data. These systems for response criteria for first-line treatment of glioblastomas include 9:"
"RANO criteria (most commonly used today)"
"RTOG 0825 criteria"
"BT-RADS"
"Macdonald criteria"
"should not have elevated choline"
"should not have elevated rCBV"
Expected headings
"IDH-wildtype"
"Multiforme and GBM"
"Primary and secondary"
"Variants"
"Cellular variants"
"FDG-PET"
"Radiogenomics"
"Surgery"
"Adjuvant chemoradiotherapy"
"Recurrent/progressive glioblastoma"
"Prognosis"
"Follow-up"
"Immediate post-operative imaging"
"Ongoing imaging"
"Response assessment criteria"
"Glioblastoma was previously known as glioblastoma multiforme; the multiforme referred to the tumour heterogeneity. In the revised 4th edition (2016) of the WHO classification, the term "multiforme" was dropped, and these tumours were referred to simply as glioblastomas. In the revised 4th edition, the abbreviation GBM was kept for disambiguation 16, however, it no longer appears in the 5th edition summary 20. Nonetheless, GBM remains widely used in routine clinical practice."
"Glioblastomas had traditionally been divided into primary and secondary; the former arising de novo (90%) and the latter developing from a pre-existing lower-grade tumour (10%)."
"The vast majority of glioblastomas are sporadic; only 5% of gliomas are familial 34. Within this group, a smaller subset (approximately 1-2%) is transmitted in a Mendelian pattern as part of recognised hereditary syndromes 36."
"Areas of necrosis are typically surrounded by elongated cells arranged in parallel, orthogonal to the necrotic centre; this is known as pseudopalisading and is fairly unique to glioblastoma 2,20,27."
"The original term glioblastoma multiforme was coined in 1926 by Percival Bailey and Harvey Cushing; the suffix multiforme was given to describe the various appearances of haemorrhage, necrosis, and cysts."
"Glioblastomas, now defined as IDH-wildtype tumours, are essentially tumours of adults, usually occurring after the age of 40 years, with a peak incidence between 55 and 75 years of age 37. There is a slight male preponderance with a 3:2 M:F ratio 37. White patients are affected more frequently than other ethnicities: the prevalence in Europe and North America is 3-6 per 100,000, whereas in Asia it is 0.59 per 100,000 16,20."
"Other, often second-line, therapies include lomustine (in combination with temozolamide in patients with MGMT methylated tumours), antiangiogenesis agents (e.g. bevacizumab), immunotherapy, and CAR-T cell therapy 28,29,34."
"deep location (e.g. thalamus)"
"lower pre-diagnosis functional status (e.g. ECOG performance status)"