• Alexander Tinchon, Franz Marhold, Bernadette Calabek-Wohinz, Katharina Hainz, Martina Tesar-Pelz, Gregory Minear, Elisabeth Freydl, Katrin Blauensteiner, Gertraud Heinz, and Stefan Oberndorfer.
• Department of Neurology, Unit for Neurooncology, University Hospital of St. Pölten-KLPU, St. Pölten, Austria.
• Wien. Klin. Wochenschr. 2021 Nov 1; 133 (21-22): 1148-1154.

BackgroundAssessment of disease activity in glioblastoma (GBM) can be challenging due to several clinical and radiological pitfalls. Besides MRI, FET-PET and neurocognitive assessment (NA) are used in several neuro-oncological centers in order to improve the specificity of response assessment. We performed a retrospective study to investigate whether the assessment by RANO (Response Assessment in NeuroOncology) corresponds to FET-PET imaging and NA results. Moreover, the concordance of RANO with a final recommendation of an interdisciplinary neuro-oncological tumor board recommendation (TBR) was analyzed.MethodsWe enrolled 25 consecutive patients with newly diagnosed histologically confirmed GBM in a pilot study, accounting for 81 multimodal test results. All patients were selected after undergoing consecutive follow-up comprising MRI, FET-PET, and NA with a subsequent TBR. Results were analyzed for correlations between RANO, FET-PET and NA. An additional consistency analysis was performed to elucidate the impact of RANO on decision making.ResultsA highly statistically significant correlation was found between RANO and FET-PET and NA results (all P < 0.01); however, 26% of follow-up tests exhibited inconsistent results in multimodal assessment, among which RANO was only 48% in accordance with the final TBR. The concordance of NA and FET-PET with the final TBR was 67% and 86%, respectively.ConclusionThe RANO proved its value in the context of multimodal assessment of disease activity in GBM; however, because the implementation of multimodal assessment showed a considerably high percentage of inconsistent results, further studies are required to investigate the relationship between different assessment techniques, in addition to their overall significance to response rating.© 2021. Springer-Verlag GmbH Austria, part of Springer Nature.

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