New Diagnostics for Gliomas

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Gliomas, the most frequent primary brain tumours, are a potentially life-threatening rare disease with poor prognosis. The most common symptoms of gliomas are due to increased intracranial pressure (headache, nausea, vomiting), seizures, focal neurological deficits and possibly cognitive deterioration. With regards to treatment, in low-grade lesions radical surgical removal will generally allow functional survival for many years. Adjuvant radiotherapy can delay disease progression and probably increases survival. For high-grade tumours surgical resection is almost always followed by radiotherapy and adjuvant chemotherapy that are usually given concomitantly. 5-year survival estimates for patients of >65 years of age diagnosed with astrocytic gliomas are only 2.5%, whereas for patients of 24-64 years of age at diagnosis 5-year survival rates are only 17.3%.

This video explains the generation of a gliomas, however, for the moment it is only available in German (link to youtube; © HD medienberatung & design; All rights reserved.)

Despite a lot of research in the field, to date there is not any clinically validated biomarker for glioma, which would be a prerequisite for reliable diagnosis and grading of glioma. Evaluation of such a biomarker with TTF/SPECT for example will benefit patients with glioma and patients with reliably excluded glioma, since both can be guided to different therapies for their particular suffering without prior brain biopsy. Currently computer tomography (CT) or magnetic resonance imaging (MRI) is necessary to identify brain lesion in general. Limitations of these methods without assessment of any validated glioma biomarker – besides high cost and limited availability – are that MRI and CT are often not able to detect low-grade gliomas or distinguish glioma from other tumours or other pathologies such as radiation necrosis or intracerebral haemorrhage. Moreover, MRI and CT are not able to grade the glioma stage. Glioma confirmation and grading still have to happen during brain surgery with biopsies and histopathology. However, reliable fast differential diagnosis and glioma grading are of utmost importance since they have immediate impact on patient management and the type of therapy.

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