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

Neuroimaging Clin N Am. 2021 Feb;31(1):103-120. doi: 10.1016/j.nic.2020.09.010.

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 / radiation effects
  • Brain Neoplasms / diagnostic imaging*
  • Brain Neoplasms / therapy*
  • Contrast Media
  • Diagnostic Imaging / methods*
  • Disease Progression
  • Fluorodeoxyglucose F18
  • Glioblastoma / diagnostic imaging*
  • Glioblastoma / pathology
  • Glioblastoma / therapy*
  • Humans
  • Image Enhancement
  • Magnetic Resonance Imaging / methods
  • Necrosis
  • Positron-Emission Tomography
  • Radiation Injuries / diagnostic imaging*
  • Radiopharmaceuticals
  • Treatment Outcome

Substances

  • Contrast Media
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18