Journal ArticleDOI
Updated Response Assessment Criteria for High-Grade Gliomas: Response Assessment in Neuro-Oncology Working Group
Patrick Y. Wen,David R. Macdonald,David A. Reardon,Timothy F. Cloughesy,A. Gregory Sorensen,Evanthia Galanis,John DeGroot,Wolfgang Wick,Mark R. Gilbert,Andrew B. Lassman,Christina Tsien,Tom Mikkelsen,Eric T. Wong,Marc C. Chamberlain,Roger Stupp,Kathleen R. Lamborn,Michael A. Vogelbaum,Martin J. van den Bent,Susan M. Chang +18 more
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TLDR
The recognition that contrast enhancement is nonspecific and may not always be a true surrogate of tumor response and the need to account for the nonenhancing component of the tumor mandate that new criteria be developed and validated to permit accurate assessment of the efficacy of novel therapies.Abstract:
Currently, the most widely used criteria for assessing response to therapy in high-grade gliomas are based on two-dimensional tumor measurements on computed tomography (CT) or magnetic resonance imaging (MRI), in conjunction with clinical assessment and corticosteroid dose (the Macdonald Criteria). It is increasingly apparent that there are significant limitations to these criteria, which only address the contrast-enhancing component of the tumor. For example, chemoradiotherapy for newly diagnosed glioblastomas results in transient increase in tumor enhancement (pseudoprogression) in 20% to 30% of patients, which is difficult to differentiate from true tumor progression. Antiangiogenic agents produce high radiographic response rates, as defined by a rapid decrease in contrast enhancement on CT/MRI that occurs within days of initiation of treatment and that is partly a result of reduced vascular permeability to contrast agents rather than a true antitumor effect. In addition, a subset of patients treated with antiangiogenic agents develop tumor recurrence characterized by an increase in the nonenhancing component depicted on T2-weighted/fluid-attenuated inversion recovery sequences. The recognition that contrast enhancement is nonspecific and may not always be a true surrogate of tumor response and the need to account for the nonenhancing component of the tumor mandate that new criteria be developed and validated to permit accurate assessment of the efficacy of novel therapies. The Response Assessment in Neuro-Oncology Working Group is an international effort to develop new standardized response criteria for clinical trials in brain tumors. In this proposal, we present the recommendations for updated response criteria for high-grade gliomas.read more
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Journal ArticleDOI
Pseudoprogression: relevance with respect to treatment of high-grade gliomas.
TL;DR: P pseudoprogression is a frequent early post-treatment imaging change that at present is not easily differentiated from tumor progression by anatomic or physiologic brain imaging and has been adopted by the Response Assessment in Neuro-Oncology Working Group.
Journal ArticleDOI
Diffusion MRI in early cancer therapeutic response assessment.
TL;DR: The introduction of quantitative DW‐MRI into the treatment management of patients with cancer may aid physicians to individualize therapy, thereby minimizing unnecessary systemic toxicity associated with ineffective therapies, saving valuable time, reducing patient care costs and ultimately improving clinical outcome.
Journal ArticleDOI
Bevacizumab for the Treatment of Glioblastoma
TL;DR: The mechanism of action of bevacizumab, its metabolism and pharmacokinetic profile, its potential side effects and complications and its place in therapy are reviewed.
Journal ArticleDOI
Diagnosis of glioma recurrence using multiparametric dynamic 18F-fluoroethyl-tyrosine PET-MRI
Thomas Pyka,Daniela Hiob,Christine Preibisch,Jens Gempt,Benedikt Wiestler,Jürgen Schlegel,Christoph Straube,Claus Zimmer +7 more
TL;DR: Simultaneous dynamic FET-PET/MRI was reliably feasible for imaging of recurrent glioma and multiparametric analysis added value especially when high specificity was demanded.
Journal ArticleDOI
Response Assessment in Neuro-Oncology Criteria for Gliomas: Practical Approach Using Conventional and Advanced Techniques.
TL;DR: The imaging findings associated with tumor progression, tumor response, pseudoprogression, and pseudoresponse according to the Response Assessment in Neuro-Oncology criteria for high-grade and lower-grade gliomas are discussed.
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Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma
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Malignant Gliomas in Adults
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