Imaging Glioblastoma Posttreatment: Progression, Pseudoprogression, Pseudoresponse, Radiation Necrosis

Radiol Clin North Am. 2019 Nov;57(6):1199-1216. doi: 10.1016/j.rcl.2019.07.003. Epub 2019 Aug 16.

Abstract

Radiographic monitoring of posttreatment glioblastoma is important for clinical trials and determining next steps in management. Evaluation for tumor progression is confounded by the presence of treatment-related radiographic changes, making a definitive determination less straight-forward. The purpose of this article was to describe imaging tools available for assessing treatment response in glioblastoma, as well as to highlight the definitions, pathophysiology, and imaging features typical of true progression, pseudoprogression, pseudoresponse, and radiation necrosis.

Keywords: Glioblastoma; Pseudoprogression; Pseudoresponse; Radiation necrosis.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / pathology
  • Brain Neoplasms / radiotherapy*
  • Diagnostic Imaging / methods*
  • Disease Progression
  • Glioblastoma / diagnostic imaging*
  • Glioblastoma / pathology
  • Glioblastoma / radiotherapy*
  • Humans
  • Magnetic Resonance Imaging
  • Magnetic Resonance Spectroscopy
  • Multimodal Imaging
  • Necrosis
  • Positron-Emission Tomography
  • Radiation Injuries / diagnostic imaging*
  • Radiation Injuries / pathology