Rivka Rachel Colen MD, Presenter: Nothing to Disclose

Saman Hazany, Abstract Co-Author: Nothing to Disclose

Pascal O. Zinn MD, Abstract Co-Author: Nothing to Disclose

Patrick Y. Wen MD, Abstract Co-Author: Nothing to Disclose

Ferenc Andras Jolesz MD, Abstract Co-Author: Consultant, Elbit Medical Imaging Ltd

1)Review the current Response Criteria for Malignant Gliomas(MacDonald Criteria) 2)Discuss/Radiographically Demonstrate Limitations of Macdonald Criteria 3)Discuss/Radiographically Demonstrate the new Response Assessment in Neuro-Oncology (RANO)Criteria 4)Discuss future role of volumetric/advanced MRI/PET

A)Current Response Criteria for Malignant Gliomas (MacDonald Criteria) 1)Definition(Table 1: Complete Response (CR)/Partial Response (PR)/Stable Disease(SD)/Progressive Disease (PD)) --Sample Cases (CR/PR/ SD/ PD) 2)MacDonalds Criteria Limitations -pseudoprogression/pseudoresponse/radiation effects/treatment effects --Sample Cases B)Newly Proposed RANO Criteria 1)Definition(Table 2: (CR/PR/ SD/ PD) --Sample Cases 2)Overcoming Macdonald Criteria (Table 3: Comparison of both criteria) C)Future Direction: Role of volumetric/advanced MRI/PET D)Summary

1)The Newly Proposed RANO Criteria account for post- treatment changes 2)RANO criteria ensures standardization in clinical trials 3)RANO criteria use FLAIR(in addition to contrast enhancement[CE]). As such, an increase in FLAIR signal in presence of stable CE during Avastin therapy reflects PD 4)Volumetrics/advanced MRI/PET(not part of RANO/Macdonald criteria)can help differentiate post-tx changes, pseudoprogression/pseudoresponse from true tumor response/progression

Colen, R, Hazany, S, Zinn, P, Wen, P, Jolesz, F, Response Assessment in Neuro-Oncology (RANO) Criteria: Redefinition of MacDonald Criteria in the Era of Modern Chemotherapy.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9006368.html