Imaging-based ascertainment of the status of key molecular alterations that are commonly found in glioma, including IDH mutational status, MGMT methylation status, EGFR copy number, and mutational status and others, could allow for molecular profiling and optimal clinical management of patients with truly inoperable tumors or with unacceptable surgical risk due to comorbidities or performance status. The gene discussed is MGMT; the disease is glioma.