Advanced magnetic resonance imaging of the physical processes in human Glioblastoma

Themost commonmalignant primary brain tumor, glioblastomamultiforme(GBM) is a devastating disease with a grim prognosis. Patient survival is typically less than two years and fewer than 10% of patients survive more than five years. Magnetic resonance imaging (MRI) can have great utility in the diagnosis, grading, and management of patients withGBMasmany of the physicalmanifestations of the pathologic processes in GBMcan be visualized and quantified using MRI. Newer MRI techniques such as dynamic contrast enhanced and dynamic susceptibility contrastMRI provide functional information about the tumor hemodynamic status. DiffusionMRI can shed light on tumor cellularity and the disruption of white matter tracts in the proximity of tumors.MRspectroscopy can be used to study newtumor tissuemarkers such as IDHmutations.MRI is helping to noninvasively explore the link between the molecular basis of gliomas and the imaging characteristics of their physical processes. We, here, review several approaches toMR-based imaging and discuss the potential for these techniques to quantify the physical processes in glioblastoma, including tumor cellularity and vascularity, metabolite expression, and patterns of tumor growth and recurrence. We conclude with challenges and opportunities for further research in applying physical principles to better understand the biologic process in this deadly disease.