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Debulking surgery is the primary diagnostic and therapeutic measure in the treatment of glioblastoma. Novel technologies allowing for more complete resection of contrast-enhancing tumor improve progression-free survival in patients with malignant gliomas.1 Postoperatively, patients with glioblastoma are routinely monitored by MRI. The first postoperative MRI is usually done immediately after surgery to assess postoperative changes. The next scan is usually done 3 months after surgery to assess the response to standard postoperative treatment: radiotherapy and temozolomide chemotherapy; as well as to evaluate radiation-induced changes.2 Some ongoing protocols have this second postoperative scan earlier, e.g., at 6 to 8 weeks. These images have to be compared to the postoperative image. In this issue of Neurology, Ulmer et al.3 present 50 consecutive patients undergoing resection of a glioblastoma. Of these patients, 70% showed …
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