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Aim. To study the role of CT perfusion in the differential diagnosis of histological subtypes of supratentorial malignant gliomas and to determine the degree of their malignancy. Materials and methods. The study included 34 patients (20 men and 14 women, with an average age of 52 years) with newly detected supratenorial glial tumors, who subsequently underwent neurosurgical treatment in the NMIC of neurosurgery with histological verification of the diagnosis. Depending on the histological diagnosis, three groups of patients were identified: 1) anaplastic astrocytomas, 2) glioblastomas, 3) anaplastic oligodendrogliomas. The CT-perfusion protocol was performed on a 64-slice Optima 660 (GE) scanner and consisted of three separate parts: a low-dose axial CT of the brain with a slice thickness of 5 mm (90 kV), a perfusion protocol performed according to a prolonged scheme, with two consecutive continuous series of scans, and a post-contrast series of CT images in a spiral scanning mode. In addition, all patients underwent an MRI examination (using a Signa Hdxt 3.0 T (GE) MR scanner, in T2, T2-FLAIR, SWAN, DWI, and T1 modes before and after contrast enhancement).Results. The study demonstrated that anaplastic astrocytomas are characterized by significantly low absolute and normalized hemodynamics parameters (BF, BV, PS) when compared with glioblastomas, and significantly low absolute maximum values of blood flow (BF) and blood volume (BV) when compared with the group of anaplastic oligodendrogliomas. CT perfusion using the normalized permeability index (PS) can reliably differentiate glioblastomas and anaplastic oligodendrogliomas. Perfusion parameters, both absolute and normalized, did not show statistically significant differences in the differential diagnosis of various molecular and genetic subtypes of anaplastic astrocytomas.Conclusion. CT perfusion using all hemodynamic parameters demonstrated high reliability and efficacy in distinguishing between glioblastomas and anaplastic astrocytomas. Further research is required to evaluate the effectiveness of the method in distinguishing glioblastomas from anaplastic oligodendrogliomas.

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Cancer cell reprogramming based on aptamers with antiproliferative properties in combination with small molecules that are used for conversion iPSCs into neurons represents a new approach to reduce the probability of glioblastoma recurrence and tumor resistance to therapy. In this research we tested several combinations of factors on whole cell cultures, derived from tumor tissue after surgical resection, and on cell cultures divided in CD133 enriched and depleted populations, as CD133 marker is believed to be characteristic for glioblastoma stem cells. We showed that CD133+ and CD133- cells have a different response to tested combinations of factors and CD133-positive cells are more stable and possess stemness properties. Thus, affecting these cells will lead to decrease of therapy resistance. Moreover, we found a combination of factors that is able to inhibit proliferation of both CD133+ and CD133- cells. Our results reveal a promising strategy to improve treatment of patients with glioblastoma.