ArticleJournal of neuro-oncology2018
Differentiating pseudoprogression from true progression: analysis of radiographic, biologic, and clinical clues in GBM.
Article in Journal of neuro-oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
28 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Spatial patterns of progression in reported glioblastoma cohorts after upfront chemoradiation and salvage therapy: a systematic review and meta-analysis.Journal of neuro-oncology · 2026Pooled it
- DEGRO practical guideline for central nervous system radiation necrosis part 1: classification and a multistep approach for diagnosis.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2022Guideline
- The diagnostic and prognosis value of dynamic contrast-enhanced MRI distributed parameter model andNeuroradiology · 2026Article
- Preliminary Usability Assessment of a Rule-Based Digital Self-Monitoring Platform for Patients With Brain Tumors Toward Digital Early Warning Systems: Pilot Feasibility Study.JMIR formative research · 2026Article
- Clinical predictors of pseudoprogression in glioblastoma: a retrospective cohort analysis.Journal of neuro-oncology · 2025Article
- A Radiologist's Guide to IDH-Wildtype Glioblastoma for Efficient Communication With Clinicians: Part II-Essential Information on Post-Treatment Imaging.Korean journal of radiology · 2025Review
- The role of FET-PET in patient selection and response assessment for reirradiation in recurrent glioblastoma.Frontiers in oncology · 2025Review
- Editorial: Updates on the management of glioblastoma.Frontiers in oncology · 2025Article
- Distinguishing glioblastoma progression from treatment-related changes using DTI directionality growth analysis.Neuroradiology · 2024Article
- A histogram of [EJNMMI research · 2024Article
- Incidence and outcome of pseudoprogression after radiation therapy in glioblastoma patients: A cohort study.Neuro-oncology practice · 2024Article
- Diagnosing pseudoprogression in glioblastoma: A challenging clinical issue.Neuro-oncology practice · 2024Article
- Assessment of treatment response to dendritic cell vaccine in patients with glioblastoma using a multiparametric MRI-based prediction model.Journal of neuro-oncology · 2023Article
- Management of initial and recurrent radiation-induced contrast enhancements following radiotherapy for brain metastases: Clinical and radiological impact of bevacizumab and corticosteroids.Clinical and translational radiation oncology · 2023Article
- RADIomic Spatial TexturAl Descriptor (RADISTAT): Quantifying Spatial Organization of Imaging Heterogeneity Associated With Tumor Response to Treatment.IEEE journal of biomedical and health informatics · 2022Article
- Pseudoprogression in Glioblastoma: Role of Metabolic and Functional MRI-Systematic Review.Biomedicines · 2022Review
- Determining the optimum tumor control probability model in radiotherapy of glioblastoma multiforme using magnetic resonance imaging data pre- and post- radiation therapy.Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences · 2022Article
- Current emerging MRI tools for radionecrosis and pseudoprogression diagnosis.Current opinion in oncology · 2021Review
- Physiological Imaging Methods for Evaluating Response to Immunotherapies in Glioblastomas.International journal of molecular sciences · 2021Review
- Dynamic Susceptibility Perfusion Imaging for Differentiating Progressive Disease from Pseudoprogression in Diffuse Glioma Molecular Subtypes.Journal of clinical medicine · 2021Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
introductionPseudoprogression (PsP) is a diagnostic dilemma in glioblastoma (GBM) after chemoradiotherapy (CRT). Magnetic resonance imaging (MRI) features may fail to distinguish PsP from early true progression (eTP), however clinical findings may aid in their distinction.
methodsSixty-seven patients received CRT for GBM between 2003 and 2016, and had pre- and post-treatment imaging suitable for retrospective evaluation using RANO criteria. Patients with signs of progression within the first 12-weeks post-radiation (P-12) were selected. Lesions that improved or stabilized were defined as PsP, and lesions that progressed were defined as eTP.
resultsThe median follow up for all patients was 17.6 months. Signs of progression developed in 35/67 (52.2%) patients within P-12. Of these, 20/35 (57.1%) were subsequently defined as eTP and 15/35 (42.9%) as PsP. MRI demonstrated increased contrast enhancement in 84.2% of eTP and 100% of PsP, and elevated CBV in 73.7% for eTP and 93.3% for PsP. A decrease in FLAIR was not seen in eTP patients, but was seen in 26.7% PsP patients. Patients with eTP were significantly more likely to require increased steroid doses or suffer clinical decline than PsP patients (OR 4.89, 95% CI 1.003-19.27; p = 0.046). KPS declined in 25% with eTP and none of the PsP patients.
conclusionsMRI imaging did not differentiate eTP from PsP, however, KPS decline or need for increased steroids was significantly more common in eTP versus PsP. Investigation and standardization of clinical assessments in response criteria may help address the diagnostic dilemma of pseudoprogression after frontline treatment for GBM.
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