Advances in neuro-oncological imaging and their impact on patient management

Abstract

Neuroradiological imaging of gliomas has undergone many advances in the recent years. Visual assessment of structural image datasets is nowadays complemented by quantifiable imaging markers to detect tumor progression and correlations with molecular markers. Detailed information about the tumor-specific pathophysiology, reflected by alterations of hemodynamics and metabolism or about tumor microstructure and infiltration of neighboring structures, is nowadays accessible noninvasively through the magnetic resonance imaging (MRI). Some of these developments have been driven by the updates of the neuropathological classification of gliomas, which now ranks genotypic markers ahead of histomorphological criteria. Neuroimaging constitutes also a key element in the diagnostic support, therapy planning, and monitoring of disease progression under therapy. While computed tomography is still of importance in emergency situations to screen for neoplastic cerebral lesions or acute complications of therapy or tumor progression, as for example, hemorrhage or seizure generation, MRI is the fundamental technology for the differential diagnosis and localization of cerebral gliomas. This review aims at providing an introduction into the most frequent clinically employed advanced magnetic resonance methods for glioma imaging.