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In recent years the amount of information concerning the genetics and the biology of gliomas, and particularly of glioblastoma multiforme, increased steadily. Such an increase has been paralleled by the technological progress of MRI. The merging of these scientific areas, as summarized in this review, is helping the stratification of glioma patients for clinical trials and their clinical follow-up. Although available therapeutic options appear limited in number, it is likely that in the next 5 years, both as a consequence of the increased knowledge due to genomic sequencing of hundreds of glioblastoma specimens and to continuous improvements of MRI, new perspectives will be available for these patients, with a sizable impact on their prognosis.