Imaging and response criteria in gliomas

Purpose of review To highlight the most recent advances in the imaging of gliomas with a focus on high-grade gliomas. In the last several years, MRI and PET imaging of the brain have moved beyond anatomic imaging and are now capable of probing different aspects of tumor biology and response to treatment. These new techniques are increasingly being incorporated into clinical trials and even into clinical practice. Therefore, it is important to be familiar with the available imaging techniques and their potential uses versus limitations. Recent findings In 2010, updated response assessment criteria for high-grade gliomas were published. It was the first revision to imaging response criteria for gliomas since 1990 and represents an international effort to standardize criteria for clinical trials. Although this revision represents an important development, there are several promising imaging techniques on the horizon such as vascular permeability measurement, perfusion imaging, diffusion imaging, and new PET tracers that will continue to improve our understanding of tumor biology. Summary Advances in neuroimaging of brain tumors are enabling investigators to noninvasively visualize tumor response to treatment over time. As these tools are validated, they will add substantially to our ability to understand glioma biology and response to therapy.