Glioblastoma, the most common and most rapidly progressing primary malignant tumor of the central nervous system, continues to portend a dismal prognosis, despite improvements in diagnostic and therapeutic strategies over the last 20 years. The standard of care radiographic characterization of glioblastoma is magnetic resonance imaging (MRI), which is a widely utilized examination in the diagnosis and post-treatment management of patients with glioblastoma. Basic MRI modalities available from any clinical scanner, including native T1-weighted (T1w) and contrast-enhanced (T1CE), T2-weighted (T2w), and T2-fluid-attenuated inversion recovery (T2-FLAIR) sequences, provide critical clinical information about various processes in the tumor environment. In the last decade, advanced MRI modalities are increasingly utilized to further characterize glioblastomas more comprehensively. These include multi-parametric MRI sequences, such as dynamic susceptibility contrast (DSC), dynamic contrast enhancement (DCE), higher order diffusion techniques such as diffusion tensor imaging (DTI), and MR spectroscopy (MRS). Significant efforts are ongoing to implement these advanced imaging modalities into improved clinical workflows and personalized therapy approaches. Functional MRI (fMRI) and tractography are increasingly being used to identify eloquent cortices and important tracts to minimize postsurgical neuro-deficits. A contemporary review of the application of standard and advanced MRI in clinical neuro-oncologic practice is presented here.

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This study extends the previous findings of a systemic treatment effect of a unique combination product, IGV-001, in recurrent GBM. As an autologous tumor cell treatment, results were postulated to be an immune response. This follow-on phase Ib trial for newly diagnosed GBM was designed to further test this hypothesis with broad entry criteria. While the primary objective remained safety, unexpected clinical and radiographic responses prompted termination of randomization and accrual only to the highest exposure cohort after patient 23. The protocol amendment also elevated analysis of clinical endpoints from exploratory objectives to clinical endpoint assessments joining the established radiographic assessments. The results of this trial reflect compelling improvement in PFS in the ITT population and for PFS, OS and PFS MGMT methylated subgroups who would have met entry criteria for current phase 3 newly-diagnosed GBM trials. These clinical endpoint improvements were accompanied by striking radiographic improvements with sustained meaningful quality of life.

In the cooling era, 47% of infants with no audible heart rate at 10 minutes and who were admitted to the neonatal intensive care unit survived; 24% without abnormalities on the brain MRI and 41% without severe abnormalities.

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