A Radiologist's Guide to IDH-Wildtype Glioblastoma for Efficient Communication With Clinicians: Part II-Essential...

Area of Science:

• Neuro-oncology
• Radiology
• Oncologic Imaging

Background:

• Advanced treatments like radiation, chemotherapy, antiangiogenic therapy, and immunotherapy complicate post-treatment imaging assessment in isocitrate dehydrogenase-wildtype glioblastoma.
• Distinguishing treatment effects from true tumor progression is a significant clinical challenge.

Purpose of the Study:

• To highlight the difficulties in radiological and clinical assessment of post-treatment imaging in isocitrate dehydrogenase-wildtype glioblastoma.
• To provide a guideline for effective communication between radiologists and clinicians for optimal patient management.

Main Methods:

• This is a review article.
• It synthesizes current knowledge on differentiating treatment-related changes from tumor progression on post-treatment imaging.
• Focuses on pseudoprogression, radiation necrosis, and pseudoresponse.

Main Results:

• Treatment-related changes (pseudoprogression, radiation necrosis, pseudoresponse) can mimic true tumor progression on imaging.
• Accurate differentiation is crucial for appropriate clinical decision-making and patient management.
• Standardized assessment criteria and clear communication are needed.

Conclusions:

• Interpreting post-treatment imaging for glioblastoma requires careful consideration of treatment effects.
• Guidelines are needed to improve the accuracy of assessing tumor progression versus treatment response.
• Enhanced communication between specialties can optimize patient care.