ReviewJournal of neuro-oncology2026
Distinguishing true progression from treatment effects in glioblastoma: a practical, evidence-graded imaging framework for the multidisciplinary team.
Review in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDistinguishing true progression (TP) from treatment effects-pseudoprogression (PsP) and radiation necrosis (RN)-after chemoradiation for glioblastoma (GBM) is a consequential, unresolved decision that conventional MRI cannot reliably make in 30-40% of cases, and that is rarely made by any single specialty alone.
methodsWe synthesized and graded evidence from RANO 2.0, advanced MRI (perfusion, diffusion, and spectroscopy), amino acid PET (per PET RANO 1.0), and radiomics, based on a literature search of PubMed/MEDLINE, Embase, and Cochrane (2010-2025).
resultsIn selected cohorts, combined MRI plus amino acid PET reports areas under the curve of 0.90-0.95 versus 0.65-0.72 for conventional MRI alone; however, these figures come from cohorts spanning the full range of post-treatment enhancement-including easily classified cases-rather than the ambiguous subset in which advanced imaging is actually used, and therefore likely overstate real-world accuracy. We organize the evidence around clinical modifiers of pretest probability-MGMT methylation, interval since chemoradiation, neurologic trajectory, antiangiogenic or immunotherapy exposure, reirradiation, and lesion location-that determine how heavily each imaging tier should be weighted. For amino acid PET, we address U.S. access, including recently published prospective and multicenter diagnostic-accuracy data for
conclusionsWe propose a tiered imaging framework-RANO 2.0 MRI → perfusion MRI → amino acid PET → tissue sampling or empirical therapy-explicitly as a structure for prospective evaluation, not a validated clinical decision tool. The principal unresolved gap is amino acid PET performance conditional on an equivocal perfusion MRI, which ongoing trials should address.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.