ArticleNeuro-oncology2025
Histopathological and molecular characteristics of IDH-wildtype glioblastoma without contrast enhancement: Implications for clinical outcomes.
Article in Neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Article
- Distinguishing Molecular and Histologic Glioblastomas Using Multiparametric MRI-Based Habitat Analysis.Korean journal of radiology · 2026Article
- Histological grade 2 and non-contrast-enhancing phenotype provide prognostic information complementary to DNA methylation classification in TERTp-mutant molecular glioblastomas.Acta neuropathologica communications · 2026Article
- The Natural Triterpenoid Alisol B Overcomes Temozolomide Resistance in Glioblastoma Through Multi-Target Mechanisms: Coordinated Epigenetic, Metabolic, and Cell-Cycle Reprogramming.International journal of molecular sciences · 2026Article
- Magnetic resonance imaging features differentiate histologic and molecular subtypes of glioblastoma IDH-Wild type CNS WHO grade 4.Journal of neuro-oncology · 2026Article
- Understanding the difference in symptoms and outcomes between glioblastoma patients diagnosed based on histological or molecular criteria: a retrospective cohort analysis from the Histo-Mol GBM collaborative.Journal of neuro-oncology · 2026Article
- Advances of MR imaging in glioma: what the neurosurgeon needs to know.Acta neurochirurgica · 2025Review
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10 authors.
Funding
Abstract
backgroundGlioblastoma (GB) heterogeneity poses substantial challenges for diagnosis and treatment. Isocitrate dehydrogenase (IDH)-wildtype GB may lack contrast enhancement on MRI and exhibit a "low-grade radiologic appearance" (non-contrast-enhancing [CE] GB), a phenomenon with unclear clinical implications. This study investigates the histopathological and molecular differences and survival outcomes between CE and non-CE GB.
methodsThis retrospective study at Heidelberg University Hospital analyzed 457 IDH-wildtype GB cases (09/2009-01/2021). Contrast enhancement on preoperative MRI was volumetrically assessed, classifying tumors as non-CE/CE GB using a 1 cm³ cutoff. Molecular and histopathological features, including microvascular proliferation, necrosis, and overall survival (OS), were compared between the groups.
resultsOf the initial cohort, 352 (77%) patients met the inclusion criteria, with 44 (12.5%) non-CE and 308 (87.5%) CE GB. The histopathological assessment revealed that non-CE GB was less likely to present traditional hallmarks of GB, such as microvascular proliferation (39% vs. 94%) and necrosis (25% vs. 92%) (P < .001). In the non-CE group, 24 patients (55%) were diagnosed as molecular GB, compared to only 8 patients (3%) in the CE group (P < .001). A significant difference was observed in Ki-67 levels, with non-CE GBs having a lower mean Ki-67 index of 18% ± 12% compared to 26% ± 13% in CE tumors (P < .001). The median OS was 27.2 months (95% CI, 19.8-NA) for non-CE and 14.7 months (95% CI, 13.2-17.1) for CE GB (P = .0049).
conclusionsIDH-wildtype GBs without contrast enhancement are often diagnosed based on molecular criteria due to less frequent histopathological hallmarks and are associated with prolonged OS.
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