RANO 2.0: Update to the response assessment for gliomas

Follow-up of patients with gliomas remains a challenge in the field of the neuro-oncology. The RANO group published its first follow-up criteria for high-grade gliomas in 2010, originally focused on clinical trials, but can served as a guide in the clinical practice. Subsequently, variations were published, including follow-up criteria for low-grade tumours, immunotherapy, and modifications to the original criteria. In 2023, they published a more comprehensive guide, RANO 2.0, which included all glioma types and different treatments. For the first time, they considered the latest WHO classification and objective data in addition to expert opinion. RANO 2.0 establishes which type of MRI should be used for the baseline MRI, describes the different responses of contrast-enhanced and non-contrast-enhanced tumour components, and determines in what circumstances a confirmatory MRI is required. In light of these changes, it is worth reviewing these new criteria to enable a better understanding of the revisions and their applicability in routine radiological practice.