Radiološka slikovna diagnostika gliomov pri odraslih Adult glioma imaging

Abstract

Gliomi so najpogostejši primarni možganski tumorji. Po novih smernicah jih razlikujemo na podlagi molekularnih markerjev, kar daje pomembno podlago za razvoj zdravljenja po meri bolnika. Tipizacija tumorjev je lahko invazivna s pomočjo biopsije in neinvazivna. Slednja v zadnjem času pridobiva veliko vlogo zaradi razvoja radiogenomike, ki proučuje povezavo med slikovnimi fenotipi tumorjev in genomiko. Magnetnoresonančna ocena tumorjev, pri kateri uporabljamo številne standardne in funkcionalne sekvence, omogoča neinvazivno tipizacijo tumorjev glede na specifične morfološke značilnosti posameznih vrst tumorjev s posameznimi molekularnimi markerji. Po pregledu obstoječe literature so avtorji v članku opisali slikovne značilnosti treh tumorskih genotipov, in sicer mutacije izocitratne dehidrogenaze, kodelecije 1p19q in metilacije promotorja metilgvanin metiltansferaze. Kljub hitremu razvoju radiogenomike primanjkuje obširnih študij z dovolj velikimi in standardiziranimi vzorci bolnikov, ki bi podale zanesljivejše rezultate.

Abstract (Eng)

Gliomas are the most commonly occurring primary brain tumours. Since recent introduction of new guidelines we distinguish between different types of primary brain tumours on the basis of molecular markers which can provide important information for personalized treatment. Tumour identification can be either invasive (biopsy based) or non-invasive. The latter has recently been getting more recognition due to development of radiogenomics, which studies the connection between tumour imaging phenotypes and genomics. Magnetic resonance imaging, which uses many standard and nonstandard sequences, can serve as non-invasive identification method for tumour genotypes based on their specific morphological features. After having overviewed the existing literature about the topic, the authors of the article have assessed the imaging features of three tumour genotypes: isocitrate dehydrogenase mutation, 1p19q codeletion and methylguanine methytransferase promoter methylation. Despite the fast development of radiogenomics, there is still lack of comprehensive studies with standardized and sufficient patient samples to present more reliable results.