Imaging Criteria in Neuro-oncology

2018 ◽  
Vol 38 (01) ◽  
pp. 024-031 ◽  
Author(s):  
Martha Nowosielski ◽  
Patrick Wen
Keyword(s):  
Clinical Trials ◽  
Brain Tumors ◽  
Imaging Techniques ◽  
Response Assessment ◽  
Pediatric Brain Tumors ◽  
Macdonald Criteria ◽  
Collective Work ◽  
Positron Emission ◽  
Oncology Clinical Trials ◽  
Group A

The identification of more effective therapies for brain tumors has been limited in part by the lack of reliable criteria for determining response and progression. Since its introduction in 1990, the MacDonald criteria have been used in neuro-oncology clinical trials to determine response, but they fail to address issues such as pseudoprogression, pseudoresponse, and nonenhancing tumor progression that have arisen with more recent therapies. The Response Assessment in Neuro-Oncology (RANO) working group, a multidisciplinary international group consisting of neuro-oncologists, medical oncologists, neuroradiologists, neurosurgeons, radiation oncologists, and neuropsychologists, was formed to improve response assessment and clinical trial endpoints in neuro-oncology. Although it was initially focused on response assessment for gliomas, the scope of the RANO group has been broadened to include brain metastases, leptomeningeal metastases, spine tumors, pediatric brain tumors, and meningiomas. In addition, subgroups have focused on response assessment during immunotherapy and use of positron emission tomography, as well as determination of neurologic function, clinical outcomes assessment, and seizures. The RANO criteria are currently a collective work in progress, and refinements will be needed in the future based on data from clinical trials and improved imaging techniques.

Clinical Trials in Pediatric Brain Tumors; Radiotherapy

2012 ◽  
pp. 183-197 ◽  
Author(s):  
Anna Skowronska-Gardas ◽  
Marzanna Chojnacka ◽  
Katarzyna Pedziwiatr
Keyword(s):  
Clinical Trials ◽  
Brain Tumors ◽  
Pediatric Brain Tumors ◽  
Pediatric Brain

scholarly journals Clinical Applications of Contrast-Enhanced Perfusion MRI Techniques in Gliomas: Recent Advances and Current Challenges

2017 ◽  
Vol 2017 ◽  
pp. 1-27 ◽  
Author(s):  
Junfeng Zhang ◽  
Heng Liu ◽  
Haipeng Tong ◽  
Sumei Wang ◽  
Yizeng Yang ◽  
...  
Keyword(s):  
Brain Tumors ◽  
Imaging Techniques ◽  
Malignant Gliomas ◽  
Response Assessment ◽  
Clinical Applications ◽  
Vascular Pathology ◽  
Molecular Characteristics ◽  
Dynamic Susceptibility ◽  
Dynamic Susceptibility Contrast ◽  
Contrast Enhanced

Gliomas possess complex and heterogeneous vasculatures with abnormal hemodynamics. Despite considerable advances in diagnostic and therapeutic techniques for improving tumor management and patient care in recent years, the prognosis of malignant gliomas remains dismal. Perfusion-weighted magnetic resonance imaging techniques that could noninvasively provide superior information on vascular functionality have attracted much attention for evaluating brain tumors. However, nonconsensus imaging protocols and postprocessing analysis among different institutions impede their integration into standard-of-care imaging in clinic. And there have been very few studies providing a comprehensive evidence-based and systematic summary. This review first outlines the status of glioma theranostics and tumor-associated vascular pathology and then presents an overview of the principles of dynamic contrast-enhanced MRI (DCE-MRI) and dynamic susceptibility contrast-MRI (DSC-MRI), with emphasis on their recent clinical applications in gliomas including tumor grading, identification of molecular characteristics, differentiation of glioma from other brain tumors, treatment response assessment, and predicting prognosis. Current challenges and future perspectives are also highlighted.

Positron emission tomography for the early postsurgical evaluation of pediatric brain tumors

2004 ◽  
Vol 21 (4) ◽  
pp. 294-300 ◽  
Author(s):  
Benoit Pirotte ◽  
Marc Levivier ◽  
Daniele Morelli ◽  
Patrick Van Bogaert ◽  
Dominique Detemmerman ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Brain Tumors ◽  
Pediatric Brain Tumors ◽  
Emission Tomography ◽  
Positron Emission ◽  
Pediatric Brain

scholarly journals Recommendations for Initial Evaluation, Staging, and Response Assessment of Hodgkin and Non-Hodgkin Lymphoma: The Lugano Classification

2014 ◽  
Vol 32 (27) ◽  
pp. 3059-3067 ◽  
Author(s):  
Bruce D. Cheson ◽  
Richard I. Fisher ◽  
Sally F. Barrington ◽  
Franco Cavalli ◽  
Lawrence H. Schwartz ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Malignant Lymphoma ◽  
Hodgkin Lymphoma ◽  
Response Assessment ◽  
Disease Extent ◽  
Single Node ◽  
Bulky Disease ◽  
International Conference ◽  
Non Hodgkin Lymphoma ◽  
Positron Emission

The purpose of this work was to modernize recommendations for evaluation, staging, and response assessment of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL). A workshop was held at the 11th International Conference on Malignant Lymphoma in Lugano, Switzerland, in June 2011, that included leading hematologists, oncologists, radiation oncologists, pathologists, radiologists, and nuclear medicine physicians, representing major international lymphoma clinical trials groups and cancer centers. Clinical and imaging subcommittees presented their conclusions at a subsequent workshop at the 12th International Conference on Malignant Lymphoma, leading to revised criteria for staging and of the International Working Group Guidelines of 2007 for response. As a result, fluorodeoxyglucose (FDG) positron emission tomography (PET)–computed tomography (CT) was formally incorporated into standard staging for FDG-avid lymphomas. A modification of the Ann Arbor descriptive terminology will be used for anatomic distribution of disease extent, but the suffixes A or B for symptoms will only be included for HL. A bone marrow biopsy is no longer indicated for the routine staging of HL and most diffuse large B-cell lymphomas. However, regardless of stage, general practice is to treat patients based on limited (stages I and II, nonbulky) or advanced (stage III or IV) disease, with stage II bulky disease considered as limited or advanced disease based on histology and a number of prognostic factors. PET-CT will be used to assess response in FDG-avid histologies using the 5-point scale. The product of the perpendicular diameters of a single node can be used to identify progressive disease. Routine surveillance scans are discouraged. These recommendations should improve evaluation of patients with lymphoma and enhance the ability to compare outcomes of clinical trials.

scholarly journals IMG-02. USEFUL DIAGNOSIS OF PEDIATRIC CYSTIC BRAIN TUMORS USING MULTIPLE POSITRON EMISSION TOMOGRAPHY STUDIES

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii354-iii355
Author(s):  
Keisuke Miyake ◽  
Takeshi Fujimori ◽  
Yasunori Toyota ◽  
Daisuke Ogawa ◽  
Tetsuhiro Hatakeyama ◽  
...  
Keyword(s):  
Positron Emission Tomography ◽  
Brain Tumors ◽  
Pilocytic Astrocytoma ◽  
Pediatric Brain Tumors ◽  
Pleomorphic Xanthoastrocytoma ◽  
Idh1 Mutation ◽  
Emission Tomography ◽  
Diffuse Astrocytoma ◽  
Positron Emission ◽  
Pediatric Brain

Abstract OBJECTIVE Pediatric brain tumors are primarily diagnosed using MRI or CT examination; however, determining the correct diagnosis using only morphological MRI can sometimes be challenging. Positron emission tomography (PET) uses radiotracers for metabolic and molecular imaging. We examined the accumulation of multiple PET (FDG, MET, FLT, and FMISO) studies for diagnosing pediatric cystic brain tumors. METHODS We performed PET scans for eight pediatric patients (five pilocytic astrocytoma, one pleomorphic xanthoastrocytoma, one diffuse astrocytoma with IDH1 mutation, one ganglioglioma) from April 2010 to December 2019. The resulting studies were compared by measuring the tumor-to-normal lesion (T/N) ratio of FDG, MET, and FLT and the tumor-to-blood value (T/B) ratio of FMISO between each pediatric cystic brain tumor. RESULTS All pediatric brain tumors showed tumor uptake of FDG, MET, and FLT. We could not examine FMISO PET for one diffuse astrocytoma with IDH1 mutation. The T/N ratios of FDG, MET, and FLT and the T/B ratio of FMISO were 1.07, 2.76, 4.6, and 1.12 for pilocytic astrocytoma; 0.65, 4.6, 7.67, and 1.38 for pleomorphic xanthoastrocytoma; 0.61, 2.14, and 3.82 for diffuse astrocytoma with IDH1 mutation; and 0.79, 1.78, 5, and 1.49 for ganglioglioma, respectively. The T/N ratios of MET and FLT for pleomorphic xanthoastrocytoma were high, but the Ki-67 labeling index was 1%. In the ganglioglioma, the T/N ratio of FLT was high, but the T/N ratio of MET was low. CONCLUSION Specialized multiple PET accumulation patterns for tumors are useful for discriminating each tumor.

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