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Publications

Journal Article Ahead of print 1 citation

PubMed: 42623110 DOI: 10.1093/neuonc/noag194

ESTRO, ESNR and EORTC consensus-based definition for MRI abnormalities after radiotherapy for intracranial central nervous system tumours.

Neuro Oncol

Authors: Lieselotte Lauwens, Catharina M L Zegers, Alida A Postma, Giuseppe Minniti, Claire Alapetite, Nicolaus Andratschke, Anna Berghoff, Malin Blomstrand, Thomas C Booth, Antonella Castellano, Anthony J Chalmers, Jan W Dankbaar, Anna Falk Delgado, Johnny Duerinck, Felix Ehret, Sara C Erridge, Enrico Franceschi, Julia Furtner, Norbert Galldiks, Semi B Harrabi, Morten Høyer, Alberto Iannalfi, Tomas Kazda, Emile Le Rhun, Ulrike Löbel, Giuseppe Lombardi, Carola Lütgendorf-Caucig, Kshitij Mankad, Pierina Navarria, Maximilian Niyazi, Teresa Nunes, Albert Pons-Escoda, Matthias Preusser, Ana Ramos, Evangelia Razis, Erik Roelofs, Roberta Rudà, Julien Savatovsky, Juan M Sepúlveda, Pia C Sundgren, Beate Timmermann, Esther G C Troost, Anouk Van der Hoorn, Damien C Weber, Michael Weller, Martin J van den Bent, Maarten Lambrecht, Marion Smits, Daniëlle B P Eekers

Affiliations

  • Department of Oncology, Laboratory of Experimental Radiotherapy, KU Leuven, Leuven, Belgium.
  • Department of Radiation Oncology (Maastro), GROW Research Institute for Oncology and Reproduction, Maastricht University Medical Centre+, Maastricht, The Netherlands.
  • Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
  • Mental Health and Neuroscience Research Institute (MHeNs), Maastricht University, Maastricht, The Netherlands.
  • Department of Radiological Sciences, Oncology and Anatomical Pathology, Sapienza University of Rome, Rome, Italy.
  • IRCCS Neuromed, Pozzilli, Italy.
  • Institut Curie, Radiation Oncology Department, Paris & Proton Center, Orsay, France.
  • Department of Radiation Oncology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.
  • Division of Oncology, Department of Medicine 1, Medical University of Vienna, Austria.
  • Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden.
  • Department of Oncology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
  • School of Biomedical Engineering & Imaging Sciences, King's College London, UK.
  • Department of Neuroradiology, Ruskin Wing, King's College Hospital NHS Foundation Trust, London, UK.
  • Neuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele and Vita-Salute San Raffaele University, Milan, Italy.
  • School of Cancer Sciences, University of Glasgow, Glasgow, UK.
  • Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
  • Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
  • Department of Neuroradiology, Karolinska University Hospital, Stockholm, Sweden.
  • Department of Neurosurgery, Universitair Ziekenhuis Brussel, Brussels, Belgium.
  • Neuroprotection and Neuromodulation (NEUR) Research Group, Center for Neurosciences (C4N), Vrije Universiteit Brussel (VUB) Brussels, Belgium.
  • Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
  • German Cancer Consortium (DKTK), partner site Berlin, a partnership between DKFZ and Charité - Universitätsmedizin Berlin, Germany.
  • Edinburgh Cancer Centre, Western General Hospital, University of Edinburgh, Edinburgh, UK.
  • Nervous System Medical Oncology Department, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
  • Research Center for Medical Image Analysis and Artificial Intelligence (MIAAI), Faculty of Medicine and Dentistry, Danube Private University, Krems, Austria.
  • Department of Neurology, Faculty of Medicine and University Hospital Cologne, Cologne, Germany, Institue of Neuroscience and Medicine (INM-3), Research Center Juelich, Juelich, Germany.
  • Center of Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Germany.
  • University Hospital Heidelberg, Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), Heidelberg, Germany.
  • Danish Centre for Particle Therapy, Aarhus University Hospital, Aarhus, Denmark.
  • Unit of Radiation Oncology, Clinical-Scientific Department, National Center for Oncological Hadrontherapy (CNAO), Pavia , Italy.
  • Department of Radiation Oncology, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
  • Department of Medical Oncology and Hematology, University Hospital and University of Zurich, Zurich, Switzerland.
  • Department of Radiology, Division of Neuroradiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
  • Department of Oncology, Oncology 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy.
  • MedAustron Ion Therapy Center, Wiener Neustadt, Austria.
  • UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
  • IRCCS Humanitas Research Hospital Rozzano, Milan, Italy.
  • Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany.
  • German Cancer Consortium (DKTK), partner site Tübingen, a partnership between DKFZ and University Hospital Tübingen, Germany Center for Neuro-Oncology, Comprehensive Cancer Center Tübingen-Stuttgart, University Hospital Tübingen, Tübingen, Germany.
  • Serviço de Neurorradiologia, Hospital Garcia de Orta, Unidade Local de Saúde de Almada-Seixal, Almada, Portugal (TN) Centro de Imagiologia, Hospital da Luz, Lisboa, Portugal.
  • Hospital Universitari de Bellvitge, Neuro-Radiology Section Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, Neuro-Oncology Unit, Barcelona, Spain.
  • Radiology, Hospital Universitario 12 de Octubre, Madrid, Spain.
  • 3rd Oncology Dept, Hygeia Hospital, Athens, Greece.
  • Division of Neuro-Oncology, Department of Neuroscience, University of Turin, Turin, Italy.
  • Department of Diagnostic Neuroradiology, Fondation Adolphe de Rothschild Hospital, Paris, France.
  • Department of Radiology, Hopital privé des peupliers, Paris, France.
  • HM Sanchinarro University Hospital, Madrid, Spain.
  • Facultad HM de Ciencias de la Salud de la Universidad Camilo José Cela (CUHMED), Madrid, Spain.
  • Instituto de Investigación Sanitaria HM Hospitales, Madrid, Spain.
  • Department of Clinical Sciences, Radiology, Lund University, Skåne University Hospital, Lund, Sweden.
  • Department of Particle Therapy, West German Proton Therapy Centre Essen (WPE), University Hospital Essen, West German Cancer Center (WTZ), German Cancer Consortium (DKTK), Essen, Germany.
  • Department of Radiotherapy and Radiation Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (EGCT), OncoRay - National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany.
  • National Center for Tumor Diseases (NCT), Partner Site Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Helmholtz Association / Helmholtz-Zentrum Dresden - Rossendorf (HZDR), Dresden, Germany.
  • German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany.
  • Helmholtz-Zentrum Dresden - Rossendorf, Institute of Radiooncology - OncoRay, Dresden, Germany.
  • University of Groningen, University Medical Center Groningen, Department of Radiology, Groningen, The Netherlands.
  • Center for Proton Therapy, Paul Scherrer Institute, Radiation Oncology Department, Bern University Hospital and University of Bern, Bern, Germany.
  • Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland.
  • the Brain Tumor Center at Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.
  • Department of Radiation-Oncology, University Hospitals Leuven, Leuven, Belgium.
  • Department of Radiology & Nuclear Medicine, Erasmus MC - University Medical Centre Rotterdam, The Netherlands.
  • Medical Delta, Delft, The Netherlands.

Abstract

Magnetic resonance imaging (MRI) is essential for post-treatment surveillance of patients with intracranial central nervous system (CNS) tumours. However, interpretation is often complicated due to post radiotherapy MRI abnormalities. Current literature demonstrates substantial heterogeneity in terminology and definitions used to describe these MRI abnormalities, limiting clinical decision-making and comparability across studies. To address this, an international multidisciplinary Delphi consensus was conducted within the Radiation Imaging and Neuro-Oncology Group (RING). Questionnaires were developed by the steering committee and distributed to experts in radiation oncology, neuroradiology, neuro-oncology, medical oncology, and neurosurgery. A three-round Delphi method was employed, with consensus defined as ≥ 75% agreement. Consensus was reached on the applicability and definitions with adoption of the term Treatment-Related Imaging Abnormality (TRIA). Clear definitions for potential and confirmed TRIA were established. Subcategorization based on imaging features all demonstrated high agreement. For consistent application of the framework minimal essential elements for MRI request forms were identified. The final consensus was endorsed by ESTRO, ESNR and EORTC. This Delphi consensus provides a standardized framework for MRI abnormalities following radiotherapy for intracranial CNS tumours. The framework aims to harmonize reporting, support clinical decision-making, and improve comparability in future neuro-oncology research. Central nervous system neoplasms - Radiotherapy - Magnetic resonance imaging - Delphi Technique - Treatment-Related Imaging Abnormality (TRIA).

MeSH

Delphi Technique, Radiotherapy, Brain Neoplasms, Clinical Decision-Making, Central Nervous System, Nervous System, Medical Oncology