Histologic Definition of Enhancing Core and FLAIR Hyperintensity Region of Glioblastoma, IDH-Wild Type: A Clinico-Pathologic Study on a Single-Institution Series

The extent of resection beyond the enhancing core (EC) in glioblastoma IDH-wild type (GBM, IDHwt) is one of the most debated topics in neuro-oncology. Indeed, it has been demonstrated that local disease recurrence often arises in peritumoral areas and that radiologically-defined FLAIR hyperintensity...

Full description

Saved in:
Bibliographic Details
Published in:Brain sciences 2023-01, Vol.13 (2), p.248
Main Authors: Broggi, Giuseppe, Altieri, Roberto, Barresi, Valeria, Certo, Francesco, Barbagallo, Giuseppe Maria Vincenzo, Zanelli, Magda, Palicelli, Andrea, Magro, Gaetano, Caltabiano, Rosario
Format: Article
Language:English
Subjects:
Aminolevulinic acid
Biopsy
Brain cancer
Brief Report
Diseases
enhancing core
FLAIR
Fluorescence
Glioblastoma
Glioblastoma multiforme
Gliosis
histopathology
Magnetic resonance imaging
Medical prognosis
Medical research
Medicine, Experimental
Morphology
Neuropathology
Oncology
Relapse
Substantia alba
Substantia grisea
Tumor cells
Tumors
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The extent of resection beyond the enhancing core (EC) in glioblastoma IDH-wild type (GBM, IDHwt) is one of the most debated topics in neuro-oncology. Indeed, it has been demonstrated that local disease recurrence often arises in peritumoral areas and that radiologically-defined FLAIR hyperintensity areas of GBM IDHwt are often visible beyond the conventional EC. Therefore, the need to extend the surgical resection also to the FLAIR hyperintensity areas is a matter of debate. Since little is known about the histological composition of FLAIR hyperintensity regions, in this study we aimed to provide a comprehensive description of the histological features of EC and FLAIR hyperintensity regions sampled intraoperatively using neuronavigation and 5-aminolevulinic acid (5-ALA) fluorescence, in 33 patients with GBM, IDHwt. Assessing a total 109 histological samples, we found that FLAIR areas consisted in: (i) fragments of white matter focally to diffusely infiltrated by tumor cells in 76% of cases; (ii) a mixture of white matter with reactive astrogliosis and grey matter with perineuronal satellitosis in 15% and (iii) tumor tissue in 9%. A deeper knowledge of the histology of FLAIR hyperintensity areas in GBM, IDH-wt may serve to better guide neurosurgeons on the choice of the most appropriate surgical approach in patients with this neoplasm.
ISSN:2076-3425
2076-3425
DOI:10.3390/brainsci13020248