neurologic disorders
Gliomas
Diagnosis of Gliomas
T1- and T2-weighted MRI Biopsy Diagnosis of gliomas is based primarily on MRI, including both standard T1- and T2-weighted imaging, preferably with gadolinium enhancement, followed by biopsy with histopathology and molecular profiling. Histopathology includes classical pathologic analysis of cellular morphology, immunohistochemical stains (eg, forIDH1/2mutations), and in situ hybridization (eg, forEGFRmutations). Selected oncogene panels, targeted or whole-exome sequencing, RNA sequencing, and/or methylguanine-DNA methyl-transferase (MGMT) methylation analysis may be done. Methylation of the MGMT gene promoter is a prognostic factor in patients with glioblastoma multiforme; it predicts a good response to postoperative temozolamide and increased survival ( Diagnosis reference ). 1.Stupp R, Taillibert S, Kanner A, et al: Effect of tumor-treating fields plus maintenancetemozolomidevs maintenancetemozolomidealone on survival in patients with glioblastoma: A randomized clinical trial.JAMA318 (23):2306–2316, 2017. doi: 10.1001/jama.2017.18718 