Evolution and implementation of radiographic response criteria in neuro-oncology

Abstract

Radiographic response assessment in neuro-oncology is critical in clinical practice and trials. Conventional criteria, such as the MacDonald and response assessment in neuro-oncology (RANO) criteria, rely on bidimensional (2D) measurements of a single tumor cross-section. Although RANO criteria are established for response assessment in clinical trials, there is a critical need to address the complexity of brain tumor treatment response with multiple new approaches being proposed. These include volumetric analysis of tumor compartments, structured MRI reporting systems like the Brain Tumor Reporting and Data System, and standardized approaches to advanced imaging techniques to distinguish tumor response from treatment effects. In this review, we discuss the strengths and limitations of different neuro-oncology response criteria and summarize current research findings on the role of novel response methods in neuro-oncology clinical trials and practice.

Basics for Pediatric Brain Tumor Imaging: Techniques and Protocol Recommendations

“…In a recent study comparing volumetric and 2D tumor assessments, inconsistent responses were noted in 20% of 70 pediatric low-grade gliomas [ 21 ]. There is ongoing research into alternative methods for evaluating treatment response including targeted therapy, with volumetric assessment showing promise [ 22 ]. Further research is required to determine its clinical usefulness for various tumor types and to establish methods for integration into routine clinical practice.…”