Glioblastoma: Epidemiology and Imaging-Based Review

Glioblastoma (GBM) is an aggressive brain tumor, commonly occurring in the frontal and temporal lobes. GBM is characterized by low survival rates, high recurrence rates, and unclear risk factors, making management a significant challenge. Anatomic magnetic resonance imaging (MRI), including T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR), is the gold standard for diagnosis of GBM. These techniques have lower accuracy in evaluating treatment response, as pseudoprogression and radionecrosis can mimic true tumor progression (TrTP). Advanced imaging options that offer physiologic information, such as diffusion- weighted imaging, MR perfusion, MR spectroscopy, and Positron Emission Tomography (PET), have shown promise in aiding diagnosis and treatment response monitoring. The first-line treatment for GBM is maximal safe neurosurgical resection, followed by adjuvant radiotherapy and temozolomide, an oral DNA alkylating agent. Current research is focused on optimizing imaging to evaluate TrTP and developing novel treatments to increase survival rates.