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A new study of 176 patients with IDH-wildtype glioblastoma (GBM) found evidence of intratumoral hemorrhage on MRI in 105 patients (59.6%). Previous studies have reported much lower rates of 2.3%-29.2%, and the authors caution that differences in MRI techniques and definitions may explain the discrepancy. The authors note their study did not use susceptibility-weighted MRI or confirm hemorrhage pathologically; therefore, 59.6% should not be interpreted as the true percentage of GBMs that hemorrhage.
The researchers found that hemorrhagic tumors had more SETD2 alterations and fewer alterations in PDGFRA, KIT, KDR and PIK3R1, genes involved in tumor growth and blood-vessel signaling. However, none of these differences remained statistically significant after correction for multiple comparisons, making the findings preliminary. Importantly, hemorrhage in GBM was not associated with shorter progression-free or overall survival. The findings suggest that the tendency of some GBMs to bleed may be linked to tumor biology, but larger studies are needed to confirm the molecular associations and determine their clinical significance.