title: Imaging biomarkers in primary brain tumours.
abstract: We are getting used to referring to instrumentally detectable biological features in medical language as "imaging biomarkers". These two terms combined reflect the evolution of medical imaging during recent decades, and conceptually comprise the principle of noninvasive detection of internal processes that can become targets for supplementary therapeutic strategies. These targets in oncology include those biological pathways that are associated with several tumour features including independence from growth and growth-inhibitory signals, avoidance of apoptosis and immune system control, unlimited potential for replication, self-sufficiency in vascular supply and neoangiogenesis, acquired tissue invasiveness and metastatic diffusion. Concerning brain tumours, there have been major improvements in neurosurgical techniques and radiotherapy planning, and developments of novel target drugs, thus increasing the need for reproducible, noninvasive, quantitative imaging biomarkers. However, in this context, conventional radiological criteria may be inappropriate to determine the best therapeutic option and subsequently to assess response to therapy. Integration of molecular imaging for the evaluation of brain tumours has for this reason become necessary, and an important role in this setting is played by imaging biomarkers in PET and MRI. In the current review, we describe most relevant techniques and biomarkers used for imaging primary brain tumours in clinical practice, and discuss potential future developments from the experimental context.
authors.affiliation: Nuclear Medicine Department, Humanitas Clinical and Research Center, Via Manzoni, 56, 20089, Rozzano, MI, Italy, egesta.lopci@cancercenter.humanitas.it.
authors.forename: Egesta
authors.initials: E
authors.lastname: Lopci
authors.forename: Ciro
authors.initials: C
authors.lastname: Franzese
authors.forename: Marco
authors.initials: M
authors.lastname: Grimaldi
authors.forename: Paolo Andrea
authors.initials: PA
authors.lastname: Zucali
authors.forename: Pierina
authors.initials: P
authors.lastname: Navarria
authors.forename: Matteo
authors.initials: M
authors.lastname: Simonelli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bello
authors.forename: Marta
authors.initials: M
authors.lastname: Scorsetti
authors.forename: Arturo
authors.initials: A
authors.lastname: Chiti
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging; D002986:Clinical Trials as Topic; D005910:Glioma / Q000175:diagnosis* / Q000000981:diagnostic imaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals
chemical_list: D014408:Biomarkers, Tumor; D019275:Radiopharmaceuticals