QUANTITATIVE MRI BIOMARKERS IN GLIOBLASTOMA: AN UPDATED REVIEW ABOUT PHYSIOPATHOLOGY, WHO CNS5 CLASSIFICATION AND CLINICAL APPLICATIONS

Melissa Garcia-Lezama¹, Edgar Teran-Davila², Sergio Moreno-Jimenez³,

Ernesto Roldan-Valadez^4,5, Sergey K. Ternovoy^5,6

 

1 - Department of Surgery, Centro Médico Nacional La Raza. Mexico City, Mexico.

2 - PECEM, Facultad de Medicina, Universidad Nacional Autónoma de México.  Mexico City, Mexico.

3 - Dirección de Cirugía, Instituto Nacional de Neurología y Neurocirugia, "Manuel Velasco Surez", Ciudad de México. Mexico City, Mexico.

4 – Instituto Nacional de Rehabilitación, Division of Research. Mexico City, Mexico.

5 - I.M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia.

6 - A.L. Myasnikov Research Institute of Clinical Cardiology of National Medical Research Center of Cardiology. Moscow, Russia...

G

lioblastoma (GBM) is the most common primary malignant brain tumour and one of the most aggressive neoplasms of the central nervous system, with a median overall survival of approximately eight months. Over the past decade, significant progress has been made in understanding its underlying pathophysiology, paralleled by advances in magnetic resonance imaging (MRI) techniques. These include functional, metabolic, and microstructural imaging modalities that enable a more comprehensive characterisation of GBM through diverse physiological and biophysical biomarkers.

A prominent development in this context is radiomics, a high-throughput image analysis approach that extracts large volumes of quantitative features from conventional and advanced imaging. Radiomics offers a non-invasive avenue to interrogate tumour biology, providing valuable insights into prognosis, treatment response, molecular classification, tumour microenvironment, and the distinction between true progression and pseudoprogression.

Despite their potential, these advanced imaging techniques are not yet widely implemented due to infrastructure limitations and the complexity of post-processing. Moreover, consensus is lacking on which radiomic features are clinically actionable, and further validation in large, multicentre studies is required before their routine clinical integration.

This review aims to provide a comprehensive overview of glioblastoma imaging, with a particular focus on the most recent and clinically relevant applications of advanced MRI techniques and radiomic analysis. We summarise current evidence on the diagnostic, prognostic, and predictive utility of radiomics in GBM, to offer clinicians a practical understanding of emerging imaging biomarkers in neuro-oncology.

 

Keywords: Glioblastoma, radiomics, magnetic resonance imaging, spectroscopy, biomarkers.

 

Corresponding author: Ernesto Roldan-Valadez, e-mail: Этот e-mail адрес защищен от спам-ботов, для его просмотра у Вас должен быть включен Javascript

For citation: Melissa Garcia-Lezama, Edgar Teran-Davila, Sergio Moreno-Jimenez, Ernesto Roldan-Valadez, Sergey K. Ternovoy. Quantitative MRI biomarkers in glioblastoma: an updated review about physiopathology, who CNS5 classification and clinical applications. REJR 2025; 15(3):6-21. DOI: 10.21569/2222-7415-2025-15-3-6-21.

Received:        21.06.25                 Accepted:       02.09.25