Optimizing glioblastoma resection: intraoperative mapping and beyond

The management of glioblastomas starts with surgical resection if possible, along with subsequent chemotherapy and radiation therapy. Several retrospective studies have suggested that extent of resection plays a role in the prognosis of glioblastoma patients. The importance of extent of resection must be balanced with preserving patient's functional status for tumors in eloquent areas. Here we review the preoperative imaging modalities such as functional MRI and magnetoencephalography (MEG), and the intraoperative techniques such as motor and language mapping, intraoperative MRI, and intraoperative techniques such as 5-aminolevulinic acid administration, that allow maximal safe operative resection of glioblastomas

BCAT1 is a New MR Imaging-related Biomarker for Prognosis Prediction in IDH1-wildtype Glioblastoma Patients

Abstract Isocitrate dehydrogenase 1 (IDH1)-wildtype glioblastoma (GBM) has found to be accompanied with increased expression of branched-chain amino acid trasaminase1 (BCAT1), which is associated with tumor growth and disease progression. In this retrospective study, quantitative RT-PCR, immunohistochemistry, and western blot were performed with GBM patient tissues to evaluate the BCAT1 level. Quantitative MR imaging parameters were evaluated from DSC perfusion imaging, DWI, contrast-enhanced T1WI and FLAIR imaging using a 3T MR scanner. The level of BCAT1 was significantly higher in IDH1-wildtype patients than in IDH1-mutant patients obtained in immunohistochemistry and western blot. The BCAT1 level was significantly correlated with the mean and 95th percentile-normalized CBV as well as the mean ADC based on FLAIR images. In addition, the 95th percentile-normalized CBV from CE T1WI also had a significant correlation with the BCAT1 level. Moreover, the median PFS in patients with BCAT1 expression <100 was longer than in those with BCAT1 expression ≥100. Taken together, we found that a high BCAT1 level is correlated with high CBV and a low ADC value as well as the poor prognosis of BCAT1 expression is related to the aggressive nature of GBM