Usefulness of preoperative extracranial imaging in radiologically suspicious glioblastoma in the West of Scotland and proposal of an imaging diagnostic pathway.

introductionA computed tomography chest, abdomen and pelvis scan (CT CAP) is probably unnecessary if a glioblastoma is detected on the initial CT brain (CTB) before more radiologically definitive magnetic resonance imaging (MRI). We audited its frequency to develop and improve our diagnostic management pathway.

methodsTwelve-month retrospective case series from 2018 of patients having an initial CTB suspicious for glioblastoma. We dichotomised patients into two groups: Group 1, tissue proven; and Group 2, non-tissue proven, owing to increased extracranial comorbidity in Group 2, which might influence a medical decision to request a CT CAP despite the radiological diagnosis of a glioblastoma being obvious on an initial CT. We quantified the frequencies of plain and contrast CTBs, CT CAPs and extracranial malignancy.

resultsIn total, 131 patients had a CTB suspicious for glioblastoma; of these, 72% had a CT CAP and 17% had extracranial malignancy. In Group 1 (

conclusionsPatients having an initial contrast CTB suggestive of glioblastoma, prior to definitive MRI, who are going to be managed surgically, having no history of extracranial malignancy, do not necessarily need a CT CAP unless MRI is non-diagnostic.