Table 1.

Neuroimaging and glioblastoma: Macdonald vs RANO criteria

	Macdonald	RANO
CR	Requires all of the following:	Requires all of the following:
	Complete disappearance of all enhancing measurable and nonmeasurable disease sustained for at least 4 wk No new lesions No corticosteroids Stable or improved clinically	Disappearance of all enhancing measurable and nonmeasurable disease sustained for a minimum of 4 wk Stable or improved FLAIR/T2 lesions No new lesions Stable or improved clinically Patients cannot be receiving corticosteroids (physiologic replacement doses are acceptable)
PR	Requires all of the following:	Requires all of the following:
	≥50% decrease compared with baseline in the sum of products of perpendicular diameters of all measurable enhancing lesions sustained for at least 4 wk No new lesions Stable or reduced corticosteroid dose Stable or improved clinically	≥50% decrease (compared with baseline) in the sum of products of perpendicular diameters of all measurable enhancing lesions sustained for a minimum of 4 wk No progression of nonmeasurable disease No new lesions Stable or improved FLAIR/T2 lesions Stable or improved clinically Corticosteroid dosage at the time of the scan should be no greater than the dosage at the time of the baseline scan
SD	Requires all of the following:	Requires all of the following:
	Does not qualify for CR, PR, or PD Stable clinically	Patient does not qualify for CR, PR, or progression Stable FLAIR/T2 lesions on a corticosteroid dose no greater than at baseline Stable clinically
PD	Defined by any of the following:	Defined by any of the following:
	≥25% increase in sum of the products of perpendicular diameters of enhancing lesions relative to best previous scan Any new lesion Clinical deterioration	≥25% increase in sum of the products of perpendicular diameters of all measurable enhancing lesions compared with the smallest tumor measurement obtained either at baseline or best response following the initiation of therapy, while on a stable or increasing dose of corticosteroids Significant increase in FLAIR/T2 lesions compared with baseline or best response following initiation of therapy, not caused by comorbid events (eg, radiation therapy, ischemic injury, seizures, postoperative changes, other treatment effects), while on a stable or increasing dose of corticosteroids New lesions Clinical deterioration not attributable to other causes apart from the tumor (eg, seizures, medication side effects, complications of therapy, cerebrovascular events, or infection) or decreases in corticosteroid dose Failure to return for evaluation owing to death or deteriorating condition Clear progression of nonmeasurable disease

Abbreviations: CR, complete response; FLAIR, fluid-attenuated inversion recovery; PD, progressive disease; PR, partial response; RANO, Response Assessment in Neuro-Oncology; SD, stable disease. (Adapted from Lutz et al.¹⁴ and Wen et al.¹⁵)