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Establishment of Orthotopic Patient-derived Xenograft Models for Brain Tumors using a Stereotaxic Device
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Pseudoprogression and pseudoresponse: challenges in brain tumor imaging.

Jennifer L Clarke1, Susan Chang

  • 1Department of Neurological Surgery, Division of Neuro-oncology, University of California-San Francisco, 400 Parnassus Avenue, A-808, Box 0372, San Francisco, CA 94143, USA. clarkej@neurosurg.ucsf.edu

Current Neurology and Neuroscience Reports
|April 8, 2009
PubMed
Summary

Assessing brain tumor treatment response with MRI is challenging due to effects like radiation necrosis and pseudoprogression that mimic tumor growth. Differentiating these imaging artifacts from true tumor progression remains a significant clinical hurdle.

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Area of Science:

  • Neuro-oncology
  • Radiology
  • Medical Imaging

Background:

  • Magnetic Resonance Imaging (MRI) is crucial for monitoring primary brain tumors.
  • Interpreting MRI findings for treatment response is complicated by treatment-induced changes.
  • Radiation necrosis and pseudoprogression can mimic tumor recurrence after therapy.

Purpose of the Study:

  • To review the challenges in brain tumor imaging for treatment response assessment.
  • To highlight the difficulties in distinguishing true tumor progression from imaging artifacts.

Main Methods:

  • Review of current literature on brain tumor imaging and treatment response.
  • Discussion of imaging findings related to radiation necrosis, pseudoprogression, and pseudoresponse.
  • Analysis of the impact of antiangiogenic therapies on imaging.

Main Results:

  • Radiation necrosis and pseudoprogression can mimic tumor progression after radiation or chemoradiotherapy.
  • Antiangiogenic therapies can cause "pseudoresponses" that complicate early treatment assessment.
  • No single adjunct imaging modality is widely accepted for differentiating true progression from pseudoprogression.

Conclusions:

  • Accurate assessment of brain tumor treatment response using current imaging techniques is difficult.
  • Distinguishing treatment effects from true tumor progression requires careful interpretation and consideration of clinical context.
  • Further research into advanced imaging techniques is needed to improve diagnostic accuracy.