Patients and Caregivers Registered Medical Practitioners
Safety Information Privacy Notice Cookie Policy Terms of Use Contact Us
What causes Glioblastoma? Read More
How is glioblastoma diagnosed and detected? Read More
A rare tumour with less than 10 per 100,000 people affected globally Read More
Metastatic Colorectal Cancer Advanced Non-Squamous Non-Small Cell Lung Cancer Recurrent Glioblastoma Metastatic Renal Cell Carcinoma Advanced Cervical Cancer Ovarian Cancer Metastatic Breast Cancer
scroll down

Recurrent Glioblastoma

Diagnosis Grade

How is glioblastoma diagnosed and detected?

Glioblastoma is detected with the aid of a host of imaging tools and techniques.

Glioblastoma is diagnosed and detected with the aid of a host of methods including imaging tools. These include:

I. Neurological examination

During a neurological examination, and based on the reported symptoms, the doctor checks vision, hearing, balance, coordination, strength and reflexes. Any problems in one or more of these areas help in providing clues on the affected part of the brain.

II. Magnetic resonance imaging (MRI)

MRI, a standard in brain tumour imaging helps define approximate boundaries of tumour including size, shape and location.

III. Computed tomography (CT or CAT scan)

During CAT scan, a computer-processed cross-sectional image of brain is generated, that allows seeing inside the brain without actual sectioning/cutting.

IV. Magnetic resonance spectroscopy (MRS)

MRS provides a metabolic profile of brain tumours by measuring the presence and levels of certain chemicals in the brain that act as indicators of the aggressiveness and extent of spread of the tumour.

V. Positron emission tomography (PET scan)

In PET scan glucose uptake by the brain is imaged using specialized fluorescent chemicals. This may be useful to differentiate tumour from surrounding tissue.

VI. Biopsy

A biopsy is the only way to definitively diagnose brain tumour and to help the doctor in deciding on the treatment decisions. During biopsy, the neurosurgeon using a needle guided by CT or MRI scanning, removes a small amount of brain tissue, which is then analysed under microscope for presence and/or physical appearance of cancer cells.

Diagnosis Grade

Once diagnosed, can one know how far the cancer might have progressed?

Glioblastoma can be classified as primary or secondary. Primary glioblastoma (GBM) accounts for majority of cases. These develop rapidly de novo, without clinical or histological evidence of a less malignant precursor lesion. They affect mainly the elderly patients.

On the other hand, secondary glioblastomas develop through progression from low-grade diffuse astrocytoma or anaplastic astrocytoma and manifest in younger patients. Also, glioblastomas are usually diagnosed as either IDH-wild type or IDH-mutant. The former (IDH-wild type) subtype is more common, tending to be more aggressive.

Abbreviations

CT/CAT scan: Computed Tomography scan GBM: Glioblastoma multiforme MRI scan: Magnetic resonance imaging scan MRS: Magnetic resonance spectroscopy PET scan: Positron emission tomography scan rGBM: Recurrent glioblastoma multiforme TMZ: temozolomide VEGF: Vascular Endothelial Growth Factor

References

  1. Hanif, F., Muzaffar, K., Perveen, K., Malhi, S. M., & Simjee, S. (2017). Glioblastoma Multiforme: A Review of its Epidemiology and Pathogenesis through Clinical Presentation and Treatment. Asian Pacific journal of cancer prevention : APJCP, 18(1), 3–9. doi:10.22034/APJCP.2017.18.1.3
  2. Rock, K., Mcardle, O., Forde, P., Dunne, M., Fitzpatrick, D., O’Neill, B., & Faul, C. (2012). A clinical review of treatment outcomes in glioblastoma multiforme—the validation in a non-trial population of the results of a randomised Phase III clinical trial: has a more radical approach improved survival? The British Journal of Radiology, 85(1017), e729-e733. doi:10.1259/bjr/83796755
  3. Loeffler, J., Alexander, E., Hochberg, F. H., Wen, P. Y., Morris, J. H., Schoene, W. C., … Black, P. M. (1990). Clinical patterns of failure following stereotactic interstitial irradiation for malignant gliomas. International Journal of Radiation Oncology Biology Physics, 19(6), 1455-1462. doi:10.1016/0360-3016(90)90358-q
  4. Gaspar, L. E., Fisher, B. J., Macdonald, D. R., Leber, D. V., Halperin, E. C., Schold, S., & Cairncross, J. (1992). Supratentorial malignant glioma: Patterns of recurrence and implications for external beam local treatment. International Journal of Radiation Oncology Biology Physics, 24(1), 55-57. doi:10.1016/0360-3016(92)91021-e
  5. Ansari, M., Nasrolahi, H., Kani, A. A., Mohammadianpanah, M., Ahmadloo, N., Omidvari, S., & Mosalaei, A. (2012). Pediatric glioblastoma multiforme: A single-institution experience. Indian journal of medical and paediatric oncology : official journal of Indian Society of Medical & Paediatric Oncology, 33(3), 155-60.
  6. Prasad, G., & Haas-Kogan, D. A.(2009).Radiation-induced gliomas.Expert review of neurotherapeutics,9(10),1511-7
  7. McKinley, B. P., Michalek, A. M., Fenstermaker, R. A., & Plunkett, R. J. (2000). The impact of age and gender on the incidence of glial tumors in New York state from 1976–1995. Journal of Neurosurgery, 93(6), 932-939. doi:10.3171/jns.2000.93.6.0932
  8. Eefje M. Sizoo, Lies Braam, Tjeerd J. Postma, H. Roeline W. Pasman, Jan J. Heimans, Martin Klein, Jaap C. Reijneveld, Martin J. B. Taphoorn, Symptoms and problems in the end-of-life phase of high-grade glioma patients, Neuro-Oncology, Volume 12, Issue 11, November 2010, Pages 1162–1166, https://doi.org/10.1093/neuonc/nop045
  9. Carlsson, S. K., Brothers, S. P., & Wahlestedt, C. (2014). Emerging treatment strategies for glioblastoma multiforme. EMBO molecular medicine, 6(11), 1359-70.
  10. Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, et al. (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352: 987–996.
  11. Friedman, H. S., Prados, M. D., Wen, P. Y., Mikkelsen, T., Schiff, D., Abrey, L. E., … Cloughesy, T. (2009). Bevacizumab Alone and in Combination With Irinotecan in Recurrent Glioblastoma. Journal of Clinical Oncology, 27(28), 4733-4740. doi:10.1200/jco.2008.19.8721
  12. Wick, W., Weller, M., Van den Bent, M., & Stupp, R. (2010). Bevacizumab and Recurrent Malignant Gliomas: A European Perspective. Journal of Clinical Oncology, 28(12), e188-e189. doi:10.1200/jco.2009.26.9027
  13. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®: Central Nervous System Cancers, Version 2.2018, Nov 26, 2018