High-grade gliomas (HGG), is the most common malignant brain tumor, with an incidence of <10 in 100.000 people (Ostrom et al, 2019). The overall prognosis is poor with a median survival of approximately 15 months with optimal treatment offered in clinical trials (Stupp et al 2005). The reported 5 year survival rate varies in the literature, depending on clinical trials or population-based studies but is usually considered less than 10% (Ostrom et al, 2019, Dressler et al 2019, Narita al, 2015, Fuentes Raspall et al, 2017, Poon et al 2019).

The complex intra-tumoral cellular heterogeneity and the intricate pattern of involved genes and underlying mutations makes glioblastoma one of the most difficult cancers to treat (Hatoum et al., 2019; Sottoriva et al, 2013, Shergalis et al., 2018). HGG invades surrounding brain tissue and exerts damaging impact on brain function. Despite considerable attempts to improve surgery, radiation, and medical treatments, no sufficient efficient therapy is available, and the unmet medical need is apparent.

Gliomas are divided into four grades according to the WHO classification with grade I being circumscribed and usually benign if sucessfully resected and grade IV, glioblastoma, being highly malignant (Louis et al, 2016).
HGG can either evolve spontaneously as de novo (primary) accounting for more than 80% of the subjects or develop from lower grade gliomas (secondary GBM) (Schouwer et al. 2017).

In HGG upregulated uPAR expression is observed (Yamamoto et al., 1994, Persson et al., 2016) and there is a significant correlation between increased uPAR expression and increased tumor grade (Salajegheh et al., 2005).

Neuro-Oncology is IAG’s area of expertise and clinical research focus. We work with biotech and pharma companies, who at the forefront of discovery and development of new treatments for brain and central nervous system tumours. IAG’s team have extensive expertise in designing and delivering trials aimed at advancing the understanding, diagnosis, and treatment of brain tumours. Areas of focus include:

  • Immunotherapy
  • Cancer genetics/genotyping
  • Targeted therapies/precision cancer medicine
  • Radiation and chemotherapy

Our scientific advisory board members and leading academic collaborators have made important inroads in basic and clinical research to better understand the biology that underlies these tumours and identify and test new therapies. IAG is involved in several global consortiums and have led the development of novel imaging endpoints in neuro-oncology.

We provide our biotech and pharma partners with extensive expertise in management and treatment development for benign and malignant brain tumors including glioma, ependymomas, glioblastoma multiforme (GBM), medulloblastomas and other adult and paediatric brain cancers.

IAG brings years of oncology, neuro-radiology and quantitative medical imaging expertise to help understanding and assessment of

  • highly complex nature of the tumour,
  • heterogenous tumour microenvironment,
  • pseudo-progression,
  • tumour volume and size changes,
  • Cellular level response.

Any successful therapy must target the inherent tumour heterogeneity. This leads to individually complex structural responses in the tumour microenvironment.

IAG’s team has deep understanding of challenges associated with design and execution of neuro-oncology trials.

We understand that optimal clinical trial design is crucial. Chosen imaging modality and associated image analysis will help to prove the efficacy of the therapy. These must show the functional and anatomical structure of the tumour and help addressing the treatment induced changes quantitatively and as early in the process as possible.

We will recommend the optimal imaging and help selecting the trial endpoints. It is often the case that conventional imaging methods such as anatomical MRI in combination with RANO are adequate, but they also may be misdealing. Once the trial is designed, IAG’s team will select and train the sites, assist with imaging data collection and review.

Reach out to our expert team, as you are designing and planning your trial.

About IAG, Image Analysis Group

IAG is a unique partner to life sciences companies developing new treatment and driving the hope of the up-coming precision medicine. IAG leverages expertise in medical imaging and the power of DYNAMIKA™, our proprietary cloud-based platform, to de-risk clinical development and deliver lifesaving therapies into the hands of patients much sooner. IAG provides early drug efficacy assessments, smart patient recruitment and predictive analysis of advanced treatment manifestations, thus lowering investment risk and accelerating study outcomes.

Acting as imaging Contract Research Organization, IAG’s experts also recognize the significance of a comprehensive approach to asset development. They actively engage in co-development projects with both private and public sectors, demonstrating a commitment to cultivating collaboration and advancing healthcare solutions.

Contact our expert team:

Experience: Scoring Systems
  • Volumetric Assessment
  • Perfusion-based Tumor Vascularity Biomarkers
  • Diffusion-based Cellular Density Biomarkers
  • Macdonald criteria
  • Machine learning techniques for grading of GBM
Experience: Imaging
  • Anatomical MRI (T1, T2, FLAIR)
  • Perfusion Imaging (DCE-MRI, DSC)
  • Diffusion Imaging (ADC, DWI, DTI)
  • Multiparametric MRI (mpMRI)
  • Contrast enhanced MRI (Gadolinium, Ferumoxytol)
  • PET/CT
  • Fluroscence Imaging

Since 2007, over 2000 articles were published to cover scientific discoveries, technology break-throughs and special cases. We list here some critically important papers and abstracts.


Combining our technologies and business advisory services with promising life science companies has yielded spectacular results over the past five years. As a trusted partner to many biotech and pharma companies, IAG’s team is proud to share your words and quotes.