The role of imaging in the management of progressive glioblastoma : a systematic review and evidence-based clinical practice guideline.

QUESTION

Which imaging techniques most accurately differentiate true tumor progression from pseudo-progression or treatment related changes in patients with previously diagnosed glioblastoma?

TARGET POPULATION

These recommendations apply to adults with previously diagnosed glioblastoma who are suspected of experiencing progression of the neoplastic process.

RECOMMENDATIONS LEVEL II

Magnetic resonance imaging with and without gadolinium enhancement is recommended as the imaging surveillance method to detect the progression of previously diagnosed glioblastoma.

LEVEL II

Magnetic resonance spectroscopy is recommended as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma.

LEVEL III

The routine use of positron emission tomography to identify progression of glioblastoma is not recommended.

LEVEL III

Single-photon emission computed tomography imaging is recommended as a diagnostic method to differentiate true tumor progression from treatment-related imaging changes or pseudo-progression in patients with suspected progressive glioblastoma.