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Distinguishing radiation necrosis from tumor progression after radiation therapy for brain metastases is challenging on conventional MRI. This study demonstrated higher normalized contrast-enhanced T1 and T2 FLAIR signal intensity for RN. Contrast-enhanced T2 FLAIR signal intensity distinguished RN and TP with an AUC similar to that of DSC perfusion.

This article is an overview of the updated version of the RANO 2.0 criteria, which are a standardized determination of radiographic response in adult gliomas on clinical trials. It provides guidance on the criteria for high- and low-grade gliomas in adults, use of the postradiotherapy MRI scan as the baseline for evaluation in newly diagnosed high-grade gliomas, the option of using volumetric tumor measurements, and the removal of subjective nonenhancing tumor evaluations in predominantly enhancing gliomas.