{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T03:52:55Z","timestamp":1790913175011,"version":"4.1.0"},"reference-count":92,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000054","name":"The National Cancer Institute","doi-asserted-by":"crossref","award":["CA274516"],"award-info":[{"award-number":["CA274516"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["3U2CHL156291-02S1"],"award-info":[{"award-number":["3U2CHL156291-02S1"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N91019D00024-75N91020F00003"],"award-info":[{"award-number":["75N91019D00024-75N91020F00003"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["75N91019D00024-75N91021F00013"],"award-info":[{"award-number":["75N91019D00024-75N91021F00013"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>MR imaging is central to the assessment of tumor burden and changes over time in neuro-oncology. Several response assessment guidelines have been set forth by the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working groups in different tumor histologies; however, the visual delineation of tumor components using MRIs is not always straightforward, and complexities not currently addressed by these criteria can introduce inter- and intra-observer variability in manual assessments. Differentiation of non-enhancing tumors from peritumoral edema, mild enhancement from absence of enhancement, and various cystic components can be challenging; particularly given a lack of sufficient and uniform imaging protocols in clinical practice. Automated tumor segmentation with artificial intelligence (AI) may be able to provide more objective delineations, but rely on accurate and consistent training data created manually (ground truth). Herein, this paper reviews existing challenges and potential solutions to identifying and defining subregions of pediatric brain tumors (PBTs) that are not explicitly addressed by current guidelines. The goal is to assert the importance of defining and adopting criteria for addressing these challenges, as it will be critical to achieving standardized tumor measurements and reproducible response assessment in PBTs, ultimately leading to more precise outcome metrics and accurate comparisons among clinical studies.<\/jats:p>","DOI":"10.1093\/neuonc\/noae093","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T01:11:25Z","timestamp":1716253885000},"page":"1557-1571","source":"Crossref","is-referenced-by-count":30,"title":["Towards consistency in pediatric brain tumor measurements: Challenges, solutions, and the role of artificial intelligence-based segmentation"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9315-8653","authenticated-orcid":false,"given":"Ariana M","family":"Familiar","sequence":"first","affiliation":[{"name":"Center for Data-Driven Discovery in Biomedicine (D3b), Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Children\u2019s Hospital of Philadelphia Department of Neurosurgery, , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anahita","family":"Fathi Kazerooni","sequence":"additional","affiliation":[{"name":"Center for Data-Driven Discovery in Biomedicine (D3b), Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Children\u2019s Hospital of Philadelphia Department of Neurosurgery, , Philadelphia, Pennsylvania , USA"},{"name":"AI2D Center for AI and Data Science for Integrated Diagnostics, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arastoo","family":"Vossough","sequence":"additional","affiliation":[{"name":"Division of Radiology, Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Center for Data-Driven Discovery in Biomedicine (D3b), Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey B","family":"Ware","sequence":"additional","affiliation":[{"name":"Department of Radiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sina","family":"Bagheri","sequence":"additional","affiliation":[{"name":"Center for Data-Driven Discovery in Biomedicine (D3b), Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Department of Radiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nastaran","family":"Khalili","sequence":"additional","affiliation":[{"name":"Center for Data-Driven Discovery in Biomedicine (D3b), Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Children\u2019s Hospital of Philadelphia Department of Neurosurgery, , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Radiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Debanjan","family":"Haldar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Thomas Jefferson University , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip B","family":"Storm","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Center for Data-Driven Discovery in Biomedicine (D3b), Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Children\u2019s Hospital of Philadelphia Department of Neurosurgery, , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam C","family":"Resnick","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Center for Data-Driven Discovery in Biomedicine (D3b), Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"},{"name":"Children\u2019s Hospital of Philadelphia Department of Neurosurgery, , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin H","family":"Kann","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Dana-Farber Cancer Institute | Brigham and Women\u2019s Hospital | Boston Children\u2019s Hospital, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariam","family":"Aboian","sequence":"additional","affiliation":[{"name":"Division of Radiology, Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7765-7690","authenticated-orcid":false,"given":"Cassie","family":"Kline","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Pediatrics, Children\u2019s Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1748-174X","authenticated-orcid":false,"given":"Michael","family":"Weller","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital and University of Zurich , Zurich , Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond Y","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, Massachusetts , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan M","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Neuro-Oncology, Department of Neurosurgery, University of California , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason R","family":"Fangusaro","sequence":"additional","affiliation":[{"name":"The Aflac Cancer Center, Children\u2019s Healthcare of Atlanta and the Emory University School of Medicine , Atlanta, Georgia , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey M","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Phoenix Children\u2019s Hospital , Phoenix, Arizona , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Mueller","sequence":"additional","affiliation":[{"name":"Department of Neurology, Neurosurgery and Pediatrics, University of California , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9630-2075","authenticated-orcid":false,"given":"Michael","family":"Prados","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Pediatrics, University of California , San Francisco, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0380-4552","authenticated-orcid":false,"given":"Ali","family":"Nabavizadeh","sequence":"additional","affiliation":[{"name":"Department of Radiology, Perelman School of Medicine, University of Pennsylvania , Philadelphia, Pennsylvania , USA"},{"name":"Center for Data-Driven Discovery in Biomedicine (D3b), Children\u2019s Hospital of Philadelphia , Philadelphia, Pennsylvania , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"issue":"11","key":"2024090518412006000_CIT0001","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/ncponc1204","article-title":"Response criteria for glioma","volume":"5","author":"Sorensen","year":"2008","journal-title":"Nat Clin Pract 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Oncol."},{"issue":"2","key":"2024090518412006000_CIT0010","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1093\/neuonc\/noac221","article-title":"Response assessment in pediatric craniopharyngioma: Recommendations from the Response Assessment in Pediatric Neuro-Oncology (RAPNO) Working Group","volume":"25","author":"Hoffman","year":"2023","journal-title":"Neuro-Oncology."},{"issue":"8","key":"2024090518412006000_CIT0011","doi-asserted-by":"crossref","first-page":"e393","DOI":"10.1016\/S1470-2045(22)00222-4","article-title":"Response assessment in paediatric intracranial ependymoma: Recommendations from the Response Assessment in Pediatric Neuro-Oncology (RAPNO) working group","volume":"23","author":"Lindsay","year":"2022","journal-title":"Lancet Oncol."},{"issue":"1","key":"2024090518412006000_CIT0012","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1093\/neuonc\/nox087","article-title":"Response assessment in medulloblastoma and leptomeningeal seeding tumors: 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