Brain 17 Vienna

IMAGING of TREATMENT RESPONSE PSEUDO-PROGRESSION

PSEUDO-PROGRESSION is a self-limited type of treatment-related tissue injury that is common in the first 3-6 months after TMZ and radiation therapy, and mimics tumor progression, but then stabilises and decreases (Brandsma D et al. Lancet oncol 2008) – up to 30% of high grade gliomas, also seen in low grade gliomas-

-more frequent in MGMT Met tumours

Differ from classic radiation necrosis, which can also mimics tumor progression, but is typically more severe and delayed in onset. Before RT+TMZ Before adjuvant TMZ After 2 cycles adj TMZ RANO criteria: within the first 12 weeks following completion of radiotherapy, progression can only be determined if new enhancement is seen outside of the radiation field or if there is histopathological confirmation