Department of Radiology, Dartmouth-Hitchcock Medical Center, One Medical Center Dr, Lebanon, NH 03756, USA.
Radiographics. 2011 Oct;31(6):1717-40. doi: 10.1148/rg.316115512.
Glioblastoma is a highly malignant brain tumor that relentlessly defies therapy. Efforts over the past decade have begun to tease out the biochemical details that lead to its aggressive behavior and poor prognosis. There is hope that this new understanding will lead to improved treatment strategies for patients with glioblastoma, in the form of targeted, molecularly based therapies that are individualized to specific changes in individual tumors. However, these new therapies have the potential to fundamentally alter the biologic behavior of glioblastoma and, as a result, its imaging appearance. Knowledge about common genetic alterations and the resultant cellular and tissue changes (ie, induced angiogenesis and abnormal cell survival, proliferation, and invasion) in glioblastomas is important as a basis for understanding imaging findings before treatment. It is equally critical that radiologists understand which genetic pathway is targeted by each specific therapeutic agent or class of agents in order to accurately interpret changes in the imaging appearances of treated tumors.
胶质母细胞瘤是一种高度恶性的脑肿瘤，对治疗具有极强的抵抗力。在过去十年中，人们已经开始深入研究导致其侵袭性行为和不良预后的生化细节。人们希望这种新的认识将为胶质母细胞瘤患者带来改进的治疗策略，即针对个体肿瘤中特定变化的靶向、基于分子的治疗方法。然而，这些新的治疗方法有可能从根本上改变胶质母细胞瘤的生物学行为，并因此改变其影像学表现。了解常见的遗传改变以及胶质母细胞瘤中由此产生的细胞和组织变化（即诱导的血管生成和异常细胞存活、增殖和侵袭）对于理解治疗前的影像学发现非常重要。同样重要的是，放射科医生需要了解每个特定治疗药物或药物类别针对的是哪个遗传途径，以便准确解释治疗后肿瘤影像学表现的变化。
