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The role of imaging in the management of progressive glioblastoma

A systematic review and evidence-based clinical practice guideline

  • TOPIC REVIEW & CLINICAL GUIDELINES
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Question

Which imaging techniques most accurately differentiate true tumor progression from pseudo-progression or treatment related changes in patients with previously diagnosed glioblastoma?

Target population

These recommendations apply to adults with previously diagnosed glioblastoma who are suspected of experiencing progression of the neoplastic process.

Recommendations

Level II

Magnetic resonance imaging with and without gadolinium enhancement is recommended as the imaging surveillance method to detect the progression of previously diagnosed glioblastoma.

Level II

Magnetic resonance spectroscopy is recommended as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma.

Level III

The routine use of positron emission tomography to identify progression of glioblastoma is not recommended.

Level III

Single-photon emission computed tomography imaging is recommended as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma.

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Acknowledgments

We would like to acknowledge the AANS/CNS Joint Guidelines Committee for their review, comments and suggestions, the contributions of Laura Mitchell, CNS Guidelines Manager for organizational assistance, Maxine Brown for searching for and retrieving literature and Amy Allison for reference library consultations. We would also like to acknowledge the following individual JGC members for their contributions throughout the review process: Sepideh Amin-Hanjani, MD, FAANS, FACS, FAHA, Martina Stippler, MD, Alexander Khalessi, MD, Isabelle Germano, MD, Sean D. Christie, MD, FRCS (C), Gregory J. Zipfel, MD, Zachary Litvack, MD, MCR, Ann Marie Flannery, MD, Patricia B Raksin, MD, Joshua M. Rosenow, MD, FACS, Steven Casha, MD, PhD, Julie G. Pilitsis, MD, PhD, Gabriel Zada, MD, Adair Prall, Krystal Tomei, MD, Gregory W Hawryluk, MD.

Conflict of interest (COI)

Task Force members report potential COIs prior to beginning work on the guideline and at the time of publication. COI disclosures are reviewed by the Task Force Chair and taken into consideration when determining writing assignments. Resolution of potential COIs included Task Force members were assigned to chapters that did not involve or in any way relate to the potential COIs disclosed.

Disclaimer of liability

The information in these guidelines reflects the current state of knowledge at the time of completion. The presentations are designed to provide an accurate review of the subject matter covered. These guidelines are disseminated with the understanding that the recommendations by the authors and consultants who have collaborated in their development are not meant to replace the individualized care and treatment advice from a patient’s physician(s). If medical advice or assistance is required, the services of a physician should be sought. The proposals contained in these guidelines may not be suitable for use in all circumstances. The choice to implement any particular recommendation contained in these guidelines must be made by a managing physician in light of the situation in each particular patient and on the basis of existing resources.

Funding source

These guidelines were funded exclusively by the CNS and Tumor Section of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons whom received no funding from outside commercial sources to support the development of this document unless otherwise stated in this section.

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Authors and Affiliations

  1. Department of Neurosurgery, Iowa Spine and Brain Institute, Waterloo, IA, USA

    Timothy Charles Ryken

  2. Department of Neurosurgery, University of Iowa, Iowa City, IA, USA

    Timothy Charles Ryken

  3. Russell H. Morgan Department of Radiology and Radiological Sciences, Division of Neuroradiology, Johns Hopkins University, Baltimore, MD, USA

    Nafi Aygun

  4. Department of Radiology, Mayo Clinic, Rochester, MN, USA

    Johnathan Morris

  5. Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA

    Marin Schweizer, Rajeshwari Nair & Cassandra Spracklen

  6. Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA

    Steven N. Kalkanis

  7. Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA

    Jeffrey J. Olson

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Correspondence to Timothy Charles Ryken.

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Ryken, T.C., Aygun, N., Morris, J. et al. The role of imaging in the management of progressive glioblastoma. J Neurooncol 118, 435–460 (2014). https://doi.org/10.1007/s11060-013-1330-0

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