Lower Grade GliomasHeterogeneity: linking imaging and molecular data to clinical behavior (6° anno)

This project focuses on Lower-Grade-Gliomas (LGGs), a hot topic in neurooncology. Their incidence is increasing; they strongly impairing the patients' ability to maintain a normal social and working life; their natural history is long, and quite variable; some are almost indolent and progress very slowly; others quickly progress to glioblastomas. Little is known about the clinical and molecular factors influencing the tendency of LGGs to progress or respond to available therapies. The importance of adding molecular data to histology for better stratifying LGGs for prognosis has been recently proposed within the integrated diagnosis. Preliminary data from our group on the use of integrated diagnosis in LGGs indicate that integrated diagnosis better stratified patients than traditional histology, but still does not fully describe the biological behavior of the tumor. Spatial heterogeneity may be one of the major determinant of the variable biological behavior of LGGs and insufficient depiction of LGGs geography by integrated diagnosis. We have consistent preliminary data showing that by combining MET-PET and MR is possible to depict LGGs spatial heterogeneity, showing that different areas of the same tumor identified by PET, express a different molecular profile, indicating that the molecular profile obtained from the most representative tumor area does not characterize the global geography of tumor.