Glioblastoma Trial With RANO Criteria

Challenge

Following chemoradiation, glioblastoma patients frequently exhibit treatment-related imaging changes that mimic tumor progression. Distinguishing pseudoprogression from true progression is among the most difficult judgments in neuro-oncology imaging, and premature or inconsistent progression determinations can distort progression-free survival analyses and lead to inappropriate treatment changes. The trial required central application of RANO and modified RANO criteria rigorous enough to manage this ambiguity uniformly across all 30 sites.

Our Solution

Intrinsic Imaging's neuroradiologists applied RANO criteria with mandatory confirmatory imaging before any progression event was finalized, ensuring that transient treatment-related changes were not misclassified as progression. Perfusion assessments were incorporated into the interpretation of suspected pseudoprogression, providing an additional physiological dimension to complement conventional morphological review. A standardized confirmation workflow governed every ambiguous case, producing a consistent and fully documented decision trail.

Results

• Reduced incidence of premature progression determinations
• Consistent confirmation workflow across sites
• Inspection-ready read audit trail