{"id":242664,"date":"2026-08-13T13:03:39","date_gmt":"2026-08-13T18:03:39","guid":{"rendered":"https:\/\/lifeboat.com\/blog\/2026\/08\/distinguishing-true-progression-from-treatment-effects-in-glioblastoma-a-practical-evidencegraded-imaging-framework-for-the-multidisciplinary-team-neurooncology"},"modified":"2026-08-13T13:03:39","modified_gmt":"2026-08-13T18:03:39","slug":"distinguishing-true-progression-from-treatment-effects-in-glioblastoma-a-practical-evidencegraded-imaging-framework-for-the-multidisciplinary-team-neurooncology","status":"publish","type":"post","link":"https:\/\/lifeboat.com\/blog\/2026\/08\/distinguishing-true-progression-from-treatment-effects-in-glioblastoma-a-practical-evidencegraded-imaging-framework-for-the-multidisciplinary-team-neurooncology","title":{"rendered":"Distinguishing true progression from treatment effects in glioblastoma: a practical, evidencegraded imaging framework for the multidisciplinary team NeuroOncology"},"content":{"rendered":"<p><a class=\"aligncenter blog-photo\" href=\"https:\/\/lifeboat.com\/blog.images\/distinguishing-true-progression-from-treatment-effects-in-glioblastoma-a-practical-evidencegraded-imaging-framework-for-the-multidisciplinary-team-neurooncology.jpg\"><\/a><\/p>\n<p>Distinguishing true progression (TP) from treatment effects\u2014pseudoprogression (PsP) and radiation necrosis (RN)\u2014after chemoradiation for glioblastoma (GBM) is a consequential, unresolved decision that conventional MRI cannot reliably make in 30\u201340% of cases, and that is rarely made by any single specialty alone.<\/p>\n<p>We 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\u20132025).<\/p>\n<p>In selected cohorts, combined MRI plus amino acid PET reports areas under the curve of 0.90\u20130.95 versus 0.65\u20130.72 for conventional MRI alone; however, these figures come from cohorts spanning the full range of post-treatment enhancement\u2014including easily classified cases\u2014rather 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\u2014MGMT methylation, interval since chemoradiation, neurologic trajectory, antiangiogenic or immunotherapy exposure, reirradiation, and lesion location\u2014that 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 <sup>18 <\/sup>F-fluciclovine.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Distinguishing true progression (TP) from treatment effects\u2014pseudoprogression (PsP) and radiation necrosis (RN)\u2014after chemoradiation for glioblastoma (GBM) is a consequential, unresolved decision that conventional MRI cannot reliably make in 30\u201340% of cases, and that is rarely made by any single specialty alone. We synthesized and graded evidence from RANO 2.0, advanced MRI (perfusion, diffusion, and spectroscopy), [\u2026]<\/p>\n","protected":false},"author":662,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-242664","post","type-post","status-publish","format-standard","hentry","category-biotech-medical"],"_links":{"self":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/242664","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/users\/662"}],"replies":[{"embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/comments?post=242664"}],"version-history":[{"count":0,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/posts\/242664\/revisions"}],"wp:attachment":[{"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/media?parent=242664"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/categories?post=242664"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/lifeboat.com\/blog\/wp-json\/wp\/v2\/tags?post=242664"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}