Scripties UMCG - Rijksuniversiteit Groningen
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Imaging Characteristics and Recurrence Patterns of the Subventricular Zone in Glioblastoma

(2016) Dijken, B.R.J. van (Bart)

Glioblastomas (GBMs) are the commonest and most malignant primary brain tumour. It is suggested that GBMs can arise from neural stem cells within the subventricular zone (SVZ). However, evidence demonstrating these cancer stem cells in GBM is lacking. This study aimed to identify the imaging characteristics of the SVZ and its relation to recurrent disease in patients with GBM by using multimodal imaging.
We included 99 primary GBM patients who underwent preoperative multimodal imaging. Follow-up data was available for 33 patients. Initial and recurrent tumours were classified into SVZ contacting and non-contacting GBMs. Diffusion and perfusion parameters were calculated in SVZ related and SVZ non-related regions.
Diffusion imaging showed signs of tumour infiltration in the SVZ with high FLAIR signal. Furthermore we found that over half of the patients with an initial SVZ non-contacting tumour recurred within the SVZ. These patients showed increased diffusion parameters in the SVZ compared to locally recurrent tumours on preoperative imaging.
Our diffusion parameters were able to show the presence of tumour cells within the SVZ, which supports the presence of a SVZ component in GBM. Preoperative evaluation of the SVZ with diffusion MRI was able to detect signs of tumour infiltration and can predict patterns of GBM recurrence within the SVZ.

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