Predicting BRAF V600E mutation in glioblastoma: utility of radiographic features

Detection of BRAF V600E mutation in glioblastomas (GBMs) is important because of potential therapeutic implications. Still, the relative paucity of these mutations makes molecular detection in all GBMs controversial. In the present study, we analyzed clinical, radiographic and pathologic features of 12 BRAF V600E-mutant GBMs and 12 matched controls from 2 institutions. We found that a majority of BRAF V600E-mutant GBMs displayed a combination of well-circumscribed lesions, large cystic components with thin walls and solid cortical component on MRI, but with some overlap with matched BRAF wildtype controls (p = 0.069). BRAF V600E-mutant GBMs were also apt to gross total resection (83% vs 17%, p = 0.016) and morphologically displayed epithelioid features (83% vs 0%, p < 0.0001). Identification of these clinical, radiographic, and pathologic characteristics should prompt testing for BRAF V600E in IDH-wildtype GBM.

Automated summary

Detecting BRAF V600E mutation in GBMs is crucial due to potential treatment implications, however, the scarcity of these mutations poses challenges for molecular testing in all GBMs. Analyzing clinical, radiographic, and pathologic features of BRAF V600E-mutant GBM compared to controls revealed specific MRI characteristics, higher likelihood of total resection, and distinctive epithelioid features, emphasizing the importance of testing for BRAF V600E in IDH-wildtype GBM.