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Advanced Imaging Techniques for Differentiating Pseudoprogression and Tumor Recurrence After Immunotherapy for Glioblastoma

Front Immunol. 2021 Nov 25:12:790674. doi: 10.3389/fimmu.2021.790674. eCollection 2021.

Abstract

Glioblastoma (GBM) is the most common malignant tumor of the central nervous system with poor prognosis. Although the field of immunotherapy in glioma is developing rapidly, glioblastoma is still prone to recurrence under strong immune intervention. The major challenges in the process of immunotherapy are evaluating the curative effect, accurately distinguishing between treatment-related reactions and tumor recurrence, and providing guidance for clinical decision-making. Since the conventional magnetic resonance imaging (MRI) is usually difficult to distinguish between pseudoprogression and the true tumor progression, many studies have used various advanced imaging techniques to evaluate treatment-related responses. Meanwhile, criteria for efficacy evaluation of immunotherapy are constantly updated and improved. A standard imaging scheme to evaluate immunotherapeutic response will benefit patients finally. This review mainly summarizes the application status and future trend of several advanced imaging techniques in evaluating the efficacy of GBM immunotherapy.

Keywords: advanced imaging; glioblastoma; immunotherapy; pseudoprogression; treatment response; tumor recurrence.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Brain Neoplasms / diagnostic imaging
  • Brain Neoplasms / immunology
  • Brain Neoplasms / pathology
  • Brain Neoplasms / therapy*
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging
  • Disease Progression
  • Glioblastoma / diagnostic imaging
  • Glioblastoma / immunology
  • Glioblastoma / pathology
  • Glioblastoma / therapy*
  • Humans
  • Immunotherapy* / adverse effects
  • Magnetic Resonance Imaging*
  • Magnetic Resonance Spectroscopy
  • Molecular Imprinting*
  • Neoplasm Recurrence, Local / diagnostic imaging*
  • Neoplasm Recurrence, Local / immunology
  • Neoplasm Recurrence, Local / pathology
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Time Factors
  • Treatment Outcome