The concepts, diagnosis and management of early imaging changes after therapy for glioblastomas

P Sanghera; R Rampling; B Haylock; S Jefferies; C McBain; J H Rees; C Soh; I R Whittle

doi:10.1016/j.clon.2011.06.004

The concepts, diagnosis and management of early imaging changes after therapy for glioblastomas

Clin Oncol (R Coll Radiol). 2012 Apr;24(3):216-27. doi: 10.1016/j.clon.2011.06.004. Epub 2011 Jul 23.

Authors

P Sanghera¹, R Rampling, B Haylock, S Jefferies, C McBain, J H Rees, C Soh, I R Whittle

Affiliation

¹ Hall-Edwards Radiotherapy Research Group, Queen Elizabeth Hospital, Birmingham, UK.

PMID: 21783349
DOI: 10.1016/j.clon.2011.06.004

Abstract

Since postoperative radiotherapy plus concomitant temozolomide followed by adjuvant temozolomide has become standard treatment for glioblastoma, the phenomenon of early post-treatment enlargement of the imaged tumour volume, usually without clinical deterioration, has become widely recognised. The term pseudoprogression has been used to describe a poorly understood pathophysiological process. In this review, the pathophysiological concepts, relevance, diagnosis and management of patients with 'pseudoprogression' and 'pseudoresponse' are discussed. Guidelines are given with respect to radiological imaging modality, mode and frequency. Further biological and clinical insights into these phenomena require carefully designed prospective studies.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Brain Neoplasms / diagnosis*
Brain Neoplasms / therapy*
Combined Modality Therapy
Diagnostic Imaging*
Disease Management
Glioblastoma / diagnosis*
Glioblastoma / therapy*
Humans