Article Figures & Data
Figures
- Fig 1.
Pseudoprogression. A 59-year-old man with GBM. An MR image obtained 1 month after RT-TMZ demonstrates an expansion of the right temporal lesion. Reductions in both the enhancing portion and the surrounding abnormal hyperintense area in the T2-weighted imaging were seen in the follow-up MR imaging examinations
- Fig 2.
Pseudoprogression. A 63-year-old man with GBM. A follow-up MR imaging examination performed 7 months after RT-TMZ demonstrates increased lesion size. The histopathology samples (not shown) demonstrated a mixed tissue with treatment-related changes, associated with a few areas of viable tumor cells.
- Fig 3.
Pseudoprogression. A 25-year-old man with a low-grade glioma in the left aspect of the pons (A, arrow) was treated with only RT. PET-MR imaging (B) showed hypermetabolism in the enhancing portion of the lesion (C). An MR imaging examination performed 1 month later (D) shows a reduction in the enhancing portion of lesion.
- Fig 4.
Pseudoresponse is characterized by a marked decreased in the enhancing portion of the lesion some months after initiation of treatment. However, in some such cases, the FLAIR sequence shows a clear expansion of the lesion.
- Fig 5.
Pseudoresponse. A 47-year-old man with GBM. A reduction of the enhancing portion of the lesion is observed 1 day after initiation of cediranib treatment. Four weeks later, besides a continuing reduction in the enhancing portion, an expansion is observed in the FLAIR images. Expansions in both the enhancing area and abnormal hyperintense areas consistent with tumor progression were observed subsequently.
Tables
Incidence of pseudoprogression
Publication No. of Patients Response Criteriaa Criteria for Early Progressionb No. of Early Progression Pseudo-Progression (% of Early Progression) Pseudo-Progression (% of Patients) Brandes et al11 103 Enhancement increase for earlier progression than Macdonald criteria 4 Weeks 50/103 32/50 32/103 J Clin Oncol 200820 (48.5%) (64%) (31%) Taal et al 85 Macdonald Criteria 4 Weeks 36/85 15/31a 15/85 Cancer 200810 (42%) (48%) (17.6%) Clarke et al 80 Increased contrast enhancement Not specified 33/80 8/25a 8/80 (abstract) J Clin Oncol 200817 (41%) (32%) (10%) Gerstner et al 45 Macdonald Criteria 17–28 Days 24/45 13/24 13/45 J Neurooncol 200918 (53%) (54%) (29%) Jefferies et al 15 Not specified 6 Months 9/15 3/9 3/15 abstract Clin Oncol 200719 (60%) (33%) (20%) Chaski et al 54 Increased contrast enhancement 6 Months 25/54 3/25 3/54 Surg Neurol 200914 (46%) (12%) (5.5%) Sanghera et al 104 RECIST 8 Weeks 27/104 7/22a 7/104 Can J Neurol Sci 201016 (26%) (32%) (7%) Mangla et al 36 Macdonald Criteria 4 Weeks 19/36 7/19 7/36 Radiology 201015 (53%) (37%) (20%)
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