Geraldo Ana Filipa, Maldonado Francisco, Severino Mariasavina, Mankad Kshitij, Dahmoush Hisham, Soares Bruno, Rugilo Carlos, Rossi Andrea
Diagnostic Neuroradiology Unit, Department of Radiology, Unidade Local de Saúde Gaia/Espinho (ULSGE), Vila Nova de Gaia, Portugal.
Department of Clinical Neurosciences and Mental Health, Faculty of Medicine of the University of Porto, Porto, Portugal.
Neuroradiology. 2024 Dec;66(12):2117-2142. doi: 10.1007/s00234-024-03493-x. Epub 2024 Oct 24.
The Response Assessment in Pediatric Neuro-Oncology (RAPNO) Working Group is an international, collaborative network of experts dedicated to pediatric central nervous system (CNS) tumors that was created in 2011. Since then, six RAPNO articles with imaging guidelines for response assessment in diverse pediatric tumor subgroups have been published, namely: 1) medulloblastomas and leptomeningeal seeding tumors (2018), 2) pediatric high-grade gliomas (2020), 3) pediatric low-grade gliomas (2020), 4) diffuse intrinsic pontine gliomas (2020), 5) pediatric intracranial ependymomas (2022) and 6) pediatric craniopharyngiomas (2023). The purpose of this article is to review all current available RAPNO criteria using a systematized and comparative approach centered on the role of neuroradiologists and supported by neuroimaging examples. Special emphasis will be placed on clarification of core concepts as well as practical adoption aspects of the RAPNO guidelines, namely how and when to image the brain and/or the spine; how to interpret the imaging findings; which other clinical, therapeutic and laboratory variables to consider; and finally how to apply the information to attribute the final appropriate response assessment classification.
小儿神经肿瘤反应评估（RAPNO）工作组是一个国际性的专家协作网络，致力于小儿中枢神经系统（CNS）肿瘤，成立于2011年。自那时以来，已发表了6篇RAPNO文章，内容涉及不同小儿肿瘤亚组反应评估的影像学指南，分别为：1）髓母细胞瘤和软脑膜播散性肿瘤（2018年），2）小儿高级别胶质瘤（2020年），3）小儿低级别胶质瘤（2020年），4）弥漫性脑桥内在型胶质瘤（2020年），5）小儿颅内室管膜瘤（2022年）和6）小儿颅咽管瘤（2023年）。本文的目的是采用一种系统化和比较性的方法，以神经放射科医生的作用为核心，并辅以神经影像学实例，对所有当前可用的RAPNO标准进行综述。将特别强调对核心概念的阐释以及RAPNO指南的实际应用方面，即何时以及如何对脑和/或脊柱进行成像；如何解读影像学检查结果；还应考虑哪些其他临床、治疗和实验室变量；最后如何应用这些信息来确定最终合适的反应评估分类。
