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Disease Markers
Volume 2018, Article ID 2908609, 11 pages
https://doi.org/10.1155/2018/2908609
Review Article

Noninvasive Glioblastoma Testing: Multimodal Approach to Monitoring and Predicting Treatment Response

1Department of Medical Oncology, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre+, P.O. Box 5800, 6202 AZ Maastricht, Netherlands
2Department of Radiotherapy (MAASTRO), School for Oncology and Developmental Biology (GROW), Maastricht University Medical Center+, Universiteitssingel 50, 6229 ER Maastricht, Netherlands
3Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, Netherlands
4Proton Therapy Department South-East Netherlands (ZON-PTC), Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, Netherlands
5Department of Neurology, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, Netherlands
6Department of Neurosurgery, Maastricht University Medical Center+, P.O. Box 5800, 6202 AZ Maastricht, Netherlands
7Department of Neurosurgery, Radboud University Medical Center, 6500 HB Nijmegen, Netherlands
8The-D-Lab: Decision Support for Precision Medicine, School for Oncology and Developmental Biology (GROW), Maastricht University Medical Centre+, Universiteitssingel 40, 6229 ER Maastricht, Netherlands

Correspondence should be addressed to Maikel Verduin; ln.cmum@niudrev.lekiam

Received 24 August 2017; Accepted 20 November 2017; Published 17 January 2018

Academic Editor: Maurizio Callari

Copyright © 2018 Maikel Verduin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Glioblastoma is the most aggressive adult primary brain tumor which is incurable despite intensive multimodal treatment. Inter- and intratumoral heterogeneity poses one of the biggest barriers in the diagnosis and treatment of glioblastoma, causing differences in treatment response and outcome. Noninvasive prognostic and predictive tests are highly needed to complement the current armamentarium. Noninvasive testing of glioblastoma uses multiple techniques that can capture the heterogeneity of glioblastoma. This set of diagnostic approaches comprises advanced MRI techniques, nuclear imaging, liquid biopsy, and new integrated approaches including radiogenomics and radiomics. New treatment options such as agents targeted at driver oncogenes and immunotherapy are currently being developed, but benefit for glioblastoma patients still has to be demonstrated. Understanding and unraveling tumor heterogeneity and microenvironment can help to create a treatment regime that is patient-tailored to these specific tumor characteristics. Improved noninvasive tests are crucial to this success. This review discusses multiple diagnostic approaches and their effect on predicting and monitoring treatment response in glioblastoma.