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Tumor Response Metrics in Neuro-Oncology: A Review

Tumor Response Metrics in Neuro-Oncology: A Review

Description & Learning Objectives
Despite the efforts spent in clinical trials in neuro-oncology during the last few decades, many challenges remain in the radiologic evaluation of brain tumors and metastases. This article aims to explain the current use of tumor metrics, especially in phase II clinical trials, to evaluate response to systemic therapy in neuro-oncology. We will discuss the imaging findings associated with progression and with partial, minor, or complete response to treatment, as well as the method of measurement, the distinction between disease-related and treatment-related changes, and inclusion of clinical symptoms to define treatment response and progression. The evaluation of response in brain tumors requires metrics that account for differences in response between high- and low-grade gliomas and specific tumor behaviors associated with radiation and immunotherapy, among other pitfalls. Advanced brain imaging techniques, such as perfusion and permeability imaging, should be incorporated into clinical trials to measure response to novel therapeutic agents more accurately.

Upon completion of this activity, participants will gain strategies to understand the role of tumor metrics analysis and the main challenges and pitfalls of applying neuro-oncology imaging criteria.
Instructions for Participation
To complete this activity, learners will read an article and submit a course evaluation. Once all elements are completed, a certificate will be automatically added to your transcript.
Credit Dates
Available: 10/10/2023
Expires: 10/9/2026

Planners & Faculty
ASNR would like to thank the following individuals for reviewing this article.
Joshua Nickerson, Editor in Chief
Toshio Moritani, Associate Editor
Meng Law, Associate Editor
Edward Escott, Associate Editor
Levi Chazen, Associate Editor
Scott Faro, Associate Editor
Susan Palasis, Associate Editor
Katyucia de Macedo Rodriguez, Associate Editor

Accreditation Statement
The American Society of Neuroradiology is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The American Society of Neuroradiology designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

In compliance with ACCME requirements and guidelines, ASNR has developed a policy for disclosure and review of potential conflicts of interest and a method for resolution if a conflict does exist. ASNR maintains a tradition of scientific integrity and objectivity in its educational activities. In order to preserve these values and ensure its educational activities are independent and free of commercial bias, all individuals, including planners, presenters, moderators and evaluators, participating in an ASNR educational activity, or an activity jointly provided by ASNR must disclose all relevant financial relationships with ineligible companies, as defined by the ACCME. Unless listed below, all planners and individuals in control of content have nothing to disclose.

Stuart Currie was supported, in part, by a grant from the Leeds Hospitals Charity. All other authors have no disclosures.

Edward Escott: Grant, Atherysys, Inc.; Royalties, Thieme Medical Publishers
Levi Chazen: Grant, Athersys; Stock Ownership or Private Investments: Amgen, Catalent, Charles River Labs, Intuitive Surgical, Stryker, United Health Group
Scott Faro: Royalties, Springer Publications