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Updated: Nov 17, 2025
Quantitative Immunohistochemistry of the Cellular Microenvironment in Patient Glioblastoma Resections
Published on: July 31, 2017
Multicentric non-enhancing lesions in glioblastoma: A retrospective study
Alexandra Benouaich-Amiel1, Vadim Khasminsky2, Omer Gal3
1Neuro-oncology Unit, Davidoff Center, Rabin Medical Center, Petah Tikva, Israel.
Abstract:
Glioblastoma (GBM) typically presents as a single lesion. Multicentric GBM are defined as well separated lesions on MRI (enhancing and non-enhancing). Multicentric GBM with non-enhancing lesions (MNE-GBM) are rarely described in literature. We aimed at describing the radiologic characteristics, treatment, and clinical course of those patients. The institutional neuropathological database was searched for GBM patients diagnosed between 1/1/2015 and 31/05/2018. All pre-operative MRI brain scans were reviewed to identify patients with MNE-GBM. Electronic medical records and follow-up MRI scans were reviewed to assess progression-free survival (PFS) and overall survival (OS). Out of 149 adult patients with newly diagnosed GBM, 12 met the inclusion criteria of MNE-GBM, all of them presented at least one enhancing lesion. Median follow-up for the MNE-GBM patients was 16.1 months. At last follow-up, all patients had recurrence (median PFS 7.6 months) and eleven patients had deceased. Median OS was 16.2 months (95% CI, 4.1-27.5). Eleven patients received radiotherapy concomitant with temozolomide as initial treatment. Radiation field included all the disease foci (enhancing and non-enhancing lesions) in 8 patients, five of them progressed within the non-enhancing lesion. Three patients did not receive radiation for the entire non-enhancing lesions, and two of them progressed within the non-irradiated areas. In conclusion, MNE-GBM is not rare, and has high risk of aggressive progression within the separate non-enhancing lesion.
Insights
Multicentric glioblastoma with non-enhancing lesions (MNE-GBM) is more common than previously thought. These aggressive tumors have a high risk of progression within separate non-enhancing lesions, impacting patient survival.
Area of Science:
- Neuro-oncology
- Radiology
- Clinical Neurology
Background:
- Glioblastoma (GBM) typically presents as a solitary lesion.
- Multicentric GBM (MGBM) involves multiple, distinct lesions on MRI.
- MGBM with non-enhancing lesions (MNE-GBM) is infrequently documented.
Purpose of the Study:
- To characterize the radiologic features of MNE-GBM.
- To analyze treatment strategies and clinical outcomes for MNE-GBM patients.
- To evaluate the progression patterns of MNE-GBM.
Main Methods:
- Retrospective review of neuropathological database (1/1/2015–31/05/2018).
- Analysis of pre-operative MRI scans to identify MNE-GBM cases.
- Review of electronic medical records and follow-up MRI for progression-free survival (PFS) and overall survival (OS) assessment.
Main Results:
- 12 MNE-GBM patients identified out of 149 newly diagnosed GBM cases.
- Median follow-up: 16.1 months; all patients experienced recurrence (median PFS: 7.6 months).
- Median OS: 16.2 months; 11 patients deceased. Progression occurred in non-enhancing lesions, even with radiation coverage.
Conclusions:
- MNE-GBM is not as rare as literature suggests.
- MNE-GBM demonstrates a high risk of aggressive progression within separate non-enhancing lesions.
- Current treatment approaches may need re-evaluation for MNE-GBM to address progression in non-enhancing components.
