Summary
This methodological paper on magnetic resonance tomography imaging recalls the assessment criteria on therapy response of Glioblastoma multiforme as defined by David Macdonald in 1990 that have remained State of the Art since their first publication. It defines the terms "pseudoprogression", "radiation induced necrosis" and "pseudoresponse". These phenomena are seen increasingly since the introduction of radiochemotherapy with Temozolomide as treatment standard in glioblastoma and since the use of antiangiogenetic therapy in malignant gliomas. Therefore, the assessment criteria have been recently updated with the newly proposed "RANO criteria (Response assessment in Neuro-Oncology)". Furthermore, the potential of additional information to conventional MR by MR perfusion, MR diffusion and MR spectroscopy is briefly discussed.
Zusammenfassung
Ausgehend von der Beurteilung des Therapieerfolgs bei Glioblastomen durch bildgebende Untersuchungen nach den Kriterien, die David Macdonald 1990 vorgeschlagen hatte und die seither unangefochten Standardinstrumente blieben, werden in diesem Beitrag die Begriffe "Pseudoprogression", "Radionekrose" und "Pseudorespons" definiert und anhand von Beispielen erklärt. Diese Phänomene werden im Zuge der Verbreitung der kombinierten Radiochemotherapie und der Einführung anti-angiogenetisch wirksamer Substanzen in die Therapie maligner Gliome häufiger beobachtet. Dies hat ein Update der Beurteilungskriterien maligner Gliome, den "RANO-Kriterien", notwendig gemacht. Außerdem werden mögliche Zusatzinformationen zur konventionellen MR-Untersuchung, die aus MR-Perfusion, MR-Diffusion und MR-Spektroskopie bei malignen Gliomen gewonnen werden kurz erläutert.
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Payer, F. Pseudoprogression oder Pseudorespons: Herausforderung an die Bildgebung des Glioblastoma multiforme. Wien Med Wochenschr 161, 13–19 (2011). https://doi.org/10.1007/s10354-010-0860-8
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DOI: https://doi.org/10.1007/s10354-010-0860-8