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.
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.
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.
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
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