Tumour progression or pseudoprogression? A review of post-treatment radiological appearances of glioblastoma.
Glioblastoma (GBM) is a common brain tumour in adults, which, despite multimodality treatment, has a poor median survival. Efficacy of therapy is assessed by clinical examination and magnetic resonance imaging (MRI) features. There is now a recognised subset of treated patients with imaging features that indicate "progressive disease" according to Macdonald's criteria, but subsequently, show stabilisation or resolution without a change in treatment. In these cases of "pseudoprogression", it is believed that non-tumoural causes lead to increased contrast enhancement and conventional MRI is inadequate in distinguishing this from true tumour progression. Incorrect diagnosis is important, as failure to identify pseudoprogression could lead to an inappropriate change of effective therapy. The purpose of this review is to outline the current research into radiological assessment with MRI and molecular imaging of post-treatment GBMs, specifically the differentiation between pseudoprogression and tumour progression.
Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK. Electronic address: sarah.abdulla@nnuh.nhs.uk.
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Abdulla
Department of Radiology, Norfolk and Norwich University Hospital, Colney Lane, Norwich NR4 7UY, UK.
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Saada
Norwich Medical School, University of East Anglia, Norwich Research Park, Norwich NR4 7TJ, UK.
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G
Johnson
Department of Oncology, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, UK.
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S
Jefferies
Department of Oncology, Addenbrookes Hospital, Hills Road, Cambridge CB2 0QQ, UK.
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Ajithkumar
D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000473:pathology* / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005909:Glioblastoma / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D057054:Molecular Imaging / Q000379:methods