Journal of Neuro-Oncology

, Volume 139, Issue 1, pp 77–88 | Cite as

Neuroimaging classification of progression patterns in glioblastoma: a systematic review

  • Rory J. Piper
  • Keerthi K. Senthil
  • Jiun-Lin Yan
  • Stephen J. Price
Clinical Study



Our primary objective was to report the current neuroimaging classification systems of spatial patterns of progression in glioblastoma. In addition, we aimed to report the terminology used to describe ‘progression’ and to assess the compliance with the Response Assessment in Neuro-Oncology (RANO) Criteria.


We conducted a systematic review to identify all neuroimaging studies of glioblastoma that have employed a categorical classification system of spatial progression patterns. Our review was registered with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) registry.


From the included 157 results, we identified 129 studies that used labels of spatial progression patterns that were not based on radiation volumes (Group 1) and 50 studies that used labels that were based on radiation volumes (Group 2). In Group 1, we found 113 individual labels and the most frequent were: local/localised (58%), distant/distal (51%), diffuse (20%), multifocal (15%) and subependymal/subventricular zone (15%). We identified 13 different labels used to refer to ‘progression’, of which the most frequent were ‘recurrence’ (99%) and ‘progression’ (92%). We identified that 37% (n = 33/90) of the studies published following the release of the RANO classification were adherent compliant with the RANO criteria.


Our review reports significant heterogeneity in the published systems used to classify glioblastoma spatial progression patterns. Standardization of terminology and classification systems used in studying progression would increase the efficiency of our research in our attempts to more successfully treat glioblastoma.


Glioblastoma Progression Recurrence Pattern Neuroimaging 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Rory J. Piper
    • 1
  • Keerthi K. Senthil
    • 1
  • Jiun-Lin Yan
    • 1
  • Stephen J. Price
    • 1
  1. 1.Cambridge Brain Tumour Imaging Laboratory, Division of Neurosurgery, Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK

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