PT  - JOURNAL ARTICLE
AU  - Ellingson, Benjamin M.
AU  - Sanvito, Francesco
AU  - Cloughesy, Timothy F.
AU  - Huang, Raymond Y.
AU  - Villanueva-Meyer, Javier E.
AU  - Pope, Whitney B.
AU  - Barboriak, Daniel P.
AU  - Shankar, Lalitha K.
AU  - Smits, Marion
AU  - Kaufmann, Timothy J.
AU  - Boxerman, Jerrold L.
AU  - Weller, Michael
AU  - Galanis, Evanthia
AU  - Groot, John de
AU  - Gilbert, Mark R.
AU  - Lassman, Andrew B.
AU  - Shiroishi, Mark S.
AU  - Nabavizadeh, Ali
AU  - Mehta, Minesh
AU  - Stupp, Roger
AU  - Wick, Wolfgang
AU  - Reardon, David A.
AU  - Vogelbaum, Michael A.
AU  - van den Bent, Martin
AU  - Chang, Susan M.
AU  - Wen, Patrick Y.
TI  - A Neuroradiologist’s Guide to Operationalizing the Response Assessment in Neuro-Oncology (RANO) Criteria Version 2.0 for Gliomas in Adults
AID  - 10.3174/ajnr.A8396
DP  - 2024 Dec 01
TA  - American Journal of Neuroradiology
PG  - 1846--1856
VI  - 45
IP  - 12
4099  - http://www.ajnr.org/content/45/12/1846.short
4100  - http://www.ajnr.org/content/45/12/1846.full
SO  - Am. J. Neuroradiol.2024 Dec 01; 45
AB  - SUMMARY: Radiographic assessment plays a crucial role in the management of patients with central nervous system (CNS) tumors, aiding in treatment planning and evaluation of therapeutic efficacy by quantifying response. Recently, an updated version of the Response Assessment in Neuro-Oncology (RANO) criteria (RANO 2.0) was developed to improve upon prior criteria and provide an updated, standardized framework for assessing treatment response in clinical trials for gliomas in adults. This article provides an overview of significant updates to the criteria including (1) the use of a unified set of criteria for high and low grade gliomas in adults; (2) the use of the post-radiotherapy MRI scan as the baseline for evaluation in newly diagnosed high-grade gliomas; (3) the option for the trial to mandate a confirmation scan to more reliably distinguish pseudoprogression from tumor progression; (4) the option of using volumetric tumor measurements; and (5) the removal of subjective non-enhancing tumor evaluations in predominantly enhancing gliomas (except for specific therapeutic modalities). Step-by-step pragmatic guidance is hereby provided for the neuroradiologist and imaging core lab involved in operationalization and technical execution of RANO 2.0 in clinical trials, including the display of representative cases and in-depth discussion of challenging scenarios.BTIPBrain Tumor Imaging ProtocolCEContrast-EnhancingCNSCentral Nervous SystemCRComplete ResponseECOGEastern Cooperative Oncology GroupHGGHigh-Grade GliomaIDHIsocitrate DehydrogenaseIRFIndependent Radiologic FacilityKPSKarnofsky Performance StatusLGGLow-Grade GliomaMRMinor ResponsemRANOModified RANONANONeurological Assessment in Neuro-OncologyORRObjective Response RateOSOverall SurvivalPDProgressive DiseasePFSProgression-Free SurvivalPRPartial ResponsePsPPseudoprogressionRANOResponse Assessment in Neuro-OncologyRECISTResponse Evaluation Criteria In Solid TumorsRTRadiation TherapySDStable DiseaseTxTreatment