RANO 2.0: critical updates and practical considerations for radiological assessment in neuro-oncology

Wen PY, van den Bent M, Youssef G, Cloughesy TF, Ellingson BM, Weller M, et al. RANO 2.0: update to the response assessment in neuro-oncology criteria for high- and low-grade gliomas in adults. J Clin Oncol. 2023;41:5187–99.

Article  PubMed  PubMed Central  Google Scholar 

Ellingson BM, Sanvito F, Cloughesy TF, Huang RY, Villanueva-Meyer JE, Pope WB, et al. A neuroradiologist’s guide to operationalizing the response assessment in neuro-oncology (RANO) criteria version 2.0 for gliomas in adults. AJNR Am J Neuroradiol. 2024;45:1846–56.

Article  PubMed  Google Scholar 

Weller M, van den Bent M, Preusser M, Le Rhun E, Tonn JC, Minniti G, et al. EANO guidelines on the diagnosis and treatment of diffuse gliomas of adulthood. Nat Rev Clin Oncol. 2021;18:170–86.

Article  PubMed  Google Scholar 

Jiang B, Chaichana K, Veeravagu A, Chang SD, Black KL, Patil CG. Biopsy versus resection for the management of low-grade gliomas. Cochrane Database Syst Rev. 2017;4: CD009319.

PubMed  Google Scholar 

Hart MG, Grant GR, Solyom EF, Grant R. Biopsy versus resection for high-grade glioma. Cochrane Database Syst Rev. 2019;6: CD002034.

PubMed  Google Scholar 

Price SJ, Gillard JH. Imaging biomarkers of brain tumour margin and tumour invasion. Br J Radiol. 2011;84(Spec No 2):S159–67.

Article  PubMed  PubMed Central  Google Scholar 

Kim YZ, Kim CY, Lim DH. The overview of practical guidelines for gliomas by KSNO, NCCN, and EANO. Brain Tumor Res Treat. 2022;10:83–93.

Article  PubMed  PubMed Central  Google Scholar 

Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352:987–96.

Article  CAS  PubMed  Google Scholar 

Nishioka K, Takahashi S, Mori T, Uchinami Y, Yamaguchi S, Kinoshita M, et al. The need of radiotherapy optimization for glioblastomas considering immune responses. Jpn J Radiol. 2023;41:1062–71.

Article  PubMed  PubMed Central  Google Scholar 

Stupp R, Taillibert S, Kanner AA, Kesari S, Steinberg DM, Toms SA, et al. Maintenance therapy with tumor-treating fields plus temozolomide vs temozolomide alone for glioblastoma: a randomized clinical trial. JAMA. 2015;314:2535–43.

Article  CAS  PubMed  Google Scholar 

Kanamori M, Tsuzuki S, Shibahara I, Saito K, Shimoda Y, Tanaka K, et al. Impact of tumor-treating fields on the survival of Japanese patients with newly diagnosed glioblastoma: a multicenter, retrospective cohort study. Neurooncol Adv. 2024;6: vdae176.

PubMed  PubMed Central  Google Scholar 

Mohamed AA, Alshaibi R, Faragalla S, Mohamed Y, Lucke-Wold B. Updates on management of gliomas in the molecular age. World J Clin Oncol. 2024;15:178–94.

Article  PubMed  PubMed Central  Google Scholar 

Birzu C, French P, Caccese M, Cerretti G, Idbaih A, Zagonel V, et al. Recurrent glioblastoma: from molecular landscape to new treatment perspectives. Cancers (Basel). 2020. https://doi.org/10.3390/cancers13010047.

Article  PubMed  Google Scholar 

Louis DN, Perry A, Wesseling P, Brat DJ, Cree IA, Figarella-Branger D, et al. The 2021 WHO classification of tumors of the central nervous system: a summary. Neuro Oncol. 2021;23:1231–51.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kurokawa R, Kurokawa M, Baba A, Ota Y, Pinarbasi E, Camelo-Piragua S, et al. Major changes in 2021 World Health Organization classification of central nervous system tumors. Radiographics. 2022;42:1474–93.

Article  PubMed  Google Scholar 

Park YW, Vollmuth P, Foltyn-Dumitru M, Sahm F, Ahn SS, Chang JH, et al. The 2021 WHO classification for gliomas and implications on imaging diagnosis: part 1-key points of the fifth edition and summary of imaging findings on adult-type diffuse gliomas. J Magn Reson Imaging. 2023;58:677–89.

Article  PubMed  Google Scholar 

Mellinghoff IK, van den Bent MJ, Blumenthal DT, Touat M, Peters KB, Clarke J, et al. Vorasidenib in IDH1- or IDH2-mutant low-grade glioma. N Engl J Med. 2023;389:589–601.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Fares J, Wan Y, Mair R, Price SJ. Molecular diversity in isocitrate dehydrogenase-wild-type glioblastoma. Brain Commun. 2024;6: fcae108.

Article  PubMed  PubMed Central  Google Scholar 

Makino Y, Arakawa Y, Yoshioka E, Shofuda T, Kawauchi T, Terada Y, et al. Prognostic stratification for IDH-wild-type lower-grade astrocytoma by Sanger sequencing and copy-number alteration analysis with MLPA. Sci Rep. 2021;11:14408.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ikeda S, Sakata A, Fushimi Y, Okuchi S, Arakawa Y, Makino Y, et al. Telomerase reverse transcriptase promoter mutation and histologic grade in IDH wild-type histological lower-grade gliomas: the value of perfusion-weighted image, diffusion-weighted image, and (18)F-FDG-PET. Eur J Radiol. 2023;159: 110658.

Article  PubMed  Google Scholar 

Komori T. Update of the 2021 WHO classification of tumors of the central nervous system: adult diffuse gliomas. Brain Tumor Pathol. 2023;40:1–3.

Article  PubMed  Google Scholar 

Brat DJ, Aldape K, Colman H, Holland EC, Louis DN, Jenkins RB, et al. cIMPACT-NOW update 3: recommended diagnostic criteria for “Diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma, WHO grade IV.” Acta Neuropathol. 2018;136:805–10.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Vollmuth P, Karschnia P, Sahm F, Park YW, Ahn SS, Jain R. A radiologist’s guide to IDH-wildtype glioblastoma for efficient communication with clinicians: part I-essential information on preoperative and immediate postoperative imaging. Korean J Radiol. 2025;26:246–68.

Article  PubMed  PubMed Central  Google Scholar 

Keric N, Krenzlin H, Kalasauskas D, Freyschlag CF, Schnell O, Misch M, et al. Treatment outcome of IDH1/2 wildtype CNS WHO grade 4 glioma histologically diagnosed as WHO grade II or III astrocytomas. J Neurooncol. 2024;167:133–44.

Article  CAS  PubMed  PubMed Central  Google Scholar 

van Dijken BRJ, Doff AR, Enting RH, van Laar PJ, Jeltema HR, Dierckx R, et al. Influence of MRI follow-up on treatment decisions during standard concomitant and adjuvant chemotherapy in patients with glioblastoma: is less more? Cancers (Basel). 2023;15:4973.

Article  PubMed  Google Scholar 

Rykkje AM, Larsen VA, Skjoth-Rasmussen J, Nielsen MB, Carlsen JF, Hansen AE. Timing of early postoperative MRI following primary glioblastoma surgery-a retrospective study of contrast enhancements in 311 patients. Diagnostics (Basel). 2023;13:795.

Article  PubMed  Google Scholar 

Jo J, van den Bent MJ, Nabors B, Wen PY, Schiff D. Surveillance imaging frequency in adult patients with lower-grade (WHO Grade 2 and 3) gliomas. Neuro Oncol. 2022;24:1035–47.

Article  PubMed  PubMed Central  Google Scholar 

Ji SY, Lee J, Lee JH, Lee ST, Won JK, Kim JW, et al. Radiological assessment schedule for high-grade glioma patients during the surveillance period using parametric modeling. Neuro Oncol. 2021;23:837–47.

Article  CAS  PubMed  Google Scholar 

Collaborative I-G, Neurology, Neurosurgery Interest G, British Neurosurgical Trainee Research C. Imaging timing after surgery for glioblastoma: an evaluation of practice in Great Britain and Ireland (INTERVAL-GB)-a multi-centre, cohort study. J Neurooncol. 2024;169:517–29.

Article  Google Scholar 

Kang H, Lee J, Ji SY, Choi SW, Kim KM, Lee JH, et al. Radiological assessment schedule for 1p/19q-codeleted gliomas during the surveillance period using parametric modeling. Neurooncol Adv. 2021;3: vdab069.

PubMed  PubMed Central  Google Scholar 

Arakawa Y, Sasaki K, Mineharu Y, Uto M, Mizowaki T, Mizusawa J, et al. A randomized phase III study of short-course radiotherapy combined with Temozolomide in elderly patients with newly diagnosed glioblastoma; Japan clinical oncology group study JCOG1910 (AgedGlio-PIII). BMC Cancer. 2021;21:1105.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Ono T, Uto M, Mineharu Y, Arakawa Y, Nakamura M, Nishio T, et al. Dummy run study for outlining and plan quality of intensity-modulated radiotherapy in elderly patients with newly diagnosed glioblastoma: the Japan clinical oncology group study JCOG1910 (AgedGlio-PIII). Radiat Oncol. 2025;20:32.

Comments (0)

No login
gif