RANO, más que ficción.

Recently, the Neuro-oncology Working Group, Response assessment in neuro-oncology (RANO) introduced new response criteria for gliomas and its clinical implication. Establishing this working-progress platform and its first report, represent an important step forward in the accurate assessment of response to therapy in patients with malignant gliomas, not only in clinical trials but also in daily practice. Anti-angiogenic therapy and other new treatment modalities have increased the incidence and our awareness of novel imaging phenomena, such as pseudoprogression and pseudoresponse not only within clinical trials, but also in clinical practice. The new RANO criteria include imaging findings and also clinical parameters, such as steroid medication and neurological symptoms into account. Neuroradiologists, oncologists and neuro-oncologists must know the criteria, apply them to standardized findings communication and gain experience in order to correctly use these information. Further research is needed to allow the inclusion of new imaging techniques, such as perfusion, diffusion-weighted imaging, spectroscopy, and volumetric measurements, which will be probably incorporated in the near future.