AT the 2025 Annual Meeting of the European Society of Radiology (ESR), M. Parillo and colleagues presented an abstract reviewing the literature on the use of Brain Tumour Reporting and Data Systems (BT-RADS) in the surveillance of adult-type diffuse gliomas.
BT-RADS was established in 2018 at Emory University by a multidisciplinary team with the aim of standardising the assessment of brain tumours on contrast-enhanced MRI following treatment. As highlighted by the authors, analysing post-surgical MRIs for gliomas can be particularly challenging, especially when it comes to distinguishing between tumour progression and treatment effects.
The system is based on a scoring range of 0 to 4, with each category further subdivided. A score of 0 reflects the initial diagnostic MRI, while scores 1 to 4 represent a continuum from decreasing tumour burden and improved treatment effects to stable disease and, ultimately, definitive tumour progression. Each score is linked to specific management recommendations, serving as a useful educational tool to assist less experienced radiologists in interpreting brain tumour images.
In the abstract, Parillo and the team highlighted several preliminary studies demonstrating the utility of BT-RADS in the surveillance of adult-type diffuse gliomas after treatment. These studies suggest the system’s potential to predict mortality and guide treatment decisions by the multidisciplinary team. However, the authors emphasised that further work is required to fully realise the benefits of this system. In particular, extensive validation through inter-rater reliability studies and greater familiarity with the system among all members of the multidisciplinary team is needed.
Finally, the authors touched on the potential implementation of artificial intelligence (AI) to semi-automatically segment tumour lesions and categorise them according to BT-RADS. This approach holds considerable promise for improving the monitoring of patients with primary brain tumours.
Helena Bradbury, EMJ
Reference
Parillo M et al. Brain tumor reporting and data system (BT-RADS) for monitoring patients with primary brain tumors. Post C-20813. Presented at ESR Annual Meeting: Feb 26 -2nd March.
