The Artificial Intelligence for RANO (AI-RANO) working group (WG) describes an international, multidisciplinary initiative that focuses on advancing the development, benchmarking, and validation of diagnostic, prognostic, and predictive AI-driven imaging biomarkers for central nervous system (CNS) tumors. We always welcome in our WG experts in clinical practice, (bio)medical imaging, machine learning, & data science who are dedicated to our focus. By fostering multi-institutional and interdisciplinary collaborations, we aim to address current challenges in accessing large and diverse clinical & imaging data essential for clinical validation. Our initiatives include conducting evidence-based reviews of emerging AI biomarkers, providing recommendations for clinical trial criteria, enabling data sharing & analysis, and collaborating with other RANO WGs & professional communities to enhance the role of AI in neuro-oncology.
Ongoing and Future projects:
1. Federated Learning for Detecting Glioma Boundaries in Post-operative MRI,
2. The BraTS Pathology (BraTS-Path) Challenge (in partnership with the RANO RPG WG),
3. Standardized review and quantification of morphological features in histopathological samples of recurrent glioma (in partnership with the RANO RPG WG),
4. Survival Prediction post-radiotherapy
Chairs:
The RANO Radiotherapy (RANO RT) WG is an international, multidisciplinary initiative, whose purpose is to define research priorities and conduct collaborative studies that will improve neuro-oncologic outcomes for patients receiving radiation therapy for central nervous system (CNS) tumors. As one of the newest WGs, RANO RT is a multidisciplinary collaboration with members from the United States and Europe, representing specialties including radiation oncology, radiation physics, neuroradiology, neurosurgery, neuro-oncology, and mathematical modeling in oncology. In addition, several RANO RT WG efforts intersect with efforts from the NIH/NCI Radiation Research Program in the Division of Cancer Treatment & Diagnosis, including research priorities in collaboration with the NIH/NCI Brain Metastases Interest Group.
Ongoing and Future projects:
1. Collaborative initiatives pertinent to ongoing and future RANO RT efforts include the development of standardized minimum data elements for patients with brain metastases to support a large-scale AI-empowered data registry. The aims of this registry include defining “high-risk” patients at risk of developing brain metastases, as well as adverse sequelae (e.g. radiation necrosis), to inform the design of next-generation clinical trials.
2. Develop an evidence-based and consensus guideline characterizing the feasibility, benefits, unique challenges, and recommendations regarding the use of advanced imaging as integral and integrated biomarkers for patient-specific radiotherapy. This initiative incorporates the paradigm of extended resection of gliomas into novel radiotherapy targeting strategies focused on the non-enhancing compartment.
3. Additional collaborations with other RANO WGs related to the incorporation of advanced imaging to enhance response assessment of glioma and to characterize imaging patterns following treatment with advanced radiation modalities.
Chairs:
The RANO Resect WG is an international, multidisciplinary effort that aims to standardize research practice by delineating the oncological role of surgery in diffuse adult-type gliomas defined per WHO 2021 classification. We aim to identify patients who are likely to benefit from more extensive resection to allow judicious surgical decision-making. In this context, we are interested in the interactive effects between resection and other prognostic clinical factors in both IDH-wildtype and -mutant gliomas. Examples for tumors where our work may guide clinical reasoning are glioblastomas, where we were able to show that supra-maximal resection beyond the contrast-enhancing tumors borders is associated with more favorable outcome in the newly diagnosed setting, but not in recurrent tumors. By emphasising the prognostic relevance of quantifying extent of resection in the setting of clinical trials, we hope to reduce imbalances between study arms by implementing a standardised terminology to describe extent of resection. Our group incorporates the views of experts in the field from surgical and medical neurological-oncology, radiation oncology, and neuropathology. Participating centers are well-established neuro-oncological referral centers in the United States, Europe, and Asia. We maintain active collaborations with other large international consortia to work in a collaborative environment on joint projects in order to optimise how we treat patients and conduct clinical research.
Ongoing and Future projects:
We are constantly conducting projects and seek to expand our clinical data registry. If you are interested to collaborate, do not hesitate to send an e-mail to Dr.Karschnia or Dr.Tonn. We are looking forward to connect.
Chairs:
RANO RGP focuses on investigating the extent to which the metrics governing the histopathological and molecular analysis of glioma in the recurrent setting can be standardized to better inform patient management.
Ongoing and Future projects:
1. The BraTS Pathology (BraTS-Path) Challenge (in partnership with the AI-RANO WG),
2. Qualitative assessment of morphological features in histopathological samples of recurrent glioma,
3. Standardized review and quantification of morphological features in histopathological samples of recurrent glioma (in partnership with the AI-RANO WG)
Chair:
The scope of the PET/RANO group is the evaluation of the clinical value of PET imaging in neuro-oncology, to define response criteria for PET, and to intergrate PET in both daliy routine and clinical trials.
Ongoing and Future projects:
1. Update of the RANO/EANO guideline for the clinical use of amino acid PET in gliomas,
2. Technical guideline (i.e., image acquisition, data evaluation, reporting of results) for PET in patients with brain metastases.
3. PET-based response criteria for brain metastases (PET-RANO BM).
4. PET-based response criteria for meningioma (PET-RANO meningioma).
Chairs:
The objectives of the Liquid Biopsy RANO (LIBI-RANO) WG are two-fold: first, to critically review the literature regarding liquid biopsy studies in CNS tumors, and second, to propose clinical applications in the setting of clinical trials.
Ongoing and Future projects:
1. Preanalytical Variables in Liquid Biopsy Approaches for Brain Tumors: A Comprehensive Review and Recommendations, in cooperation with the International Liquid Biopsy Consortium
Chair:
The RANO-TREAT WG is focusing on assessing seizures in brain tumor patients.
Ongoing and Future projects:
1. Completed a prospective study evaluating and developing a seizure assessment tool for use in brain tumor treatment trials. [Under review in Neuro-Oncology]
Chair:
The Response Assessment in Pediatric NeuroOncology (RAPNO) has a broad scope with many pediatric subcommittees including the following: LGG, HGG/DIPG, Ependymoma, Craniopharyngioma, Medulloblastoma and other Embryonal tumors, AI, pNANO, Quality of Life/Late Effects
Ongoing and Future projects:
1. The AI initiative is ongoing and volunteers are welcome (in partnership with the AI-RANO WG),
2. There will be a Sunrise Session at Peds SNO 2025 reviewing the RAPNO initiatives.
Please contact Jason Fangusaro at jfangus@emory.edu with any questions.
Chair:
The Spine Response Assessment in Neuro-Oncology (SPINO) WG aims to develop consensus on appropriate methodology for spine SBRT trials and endpoints.
Ongoing and Future projects:
1. Working on SPINO 3 as a consolidative manuscript on trial methods
Members:
Dr. Laura Burgess,
Dr. Sam Ryu,
Dr. Piet Dirix,
Dr. JJ verlaan,
Dr. Simon S. Lo,
Dr. Josh Yamada,
Dr. Charles Fisher,
Dr. Matthew Foote,
Dr. Ilya Laufer,
Dr. Matthias Guckenberger,
Dr. Scott Soltys,
Dr. Sam Chao,
Dr. Tanja Sprave,
Dr. Wendy Parulekar,
Dr. Michael A. Vogelbaum,
Dr. Perjman Jabehdar Maralani
The RANO-Cares working group was formed to develop and provide guidance on caregiver-related research outcomes in neuro-oncology trials. Following a brain tumor diagnosis, families commonly face altered priorities in their daily life and struggle to find appropriate support for managing the physical, emotional, and logistic challenges that arise. Assessing the effectiveness of caregiver interventions poses significant challenges. Apart from difficulties with recruitment and retention, as well as other methodological challenges that are not specific to neuro-oncology caregiving research, the field still lacks agreed definitions of key constructs and suffers from inconsistency in assessment, with the same construct rarely being evaluated using the same outcome measure across studies. Such variability hinders comparability between studies, limits the ability to conduct meta-analyses, and ultimately slows progress in the development, evaluation, and implementation of evidence-based caregiver support.
Future projects of the RANO-Cares working group will focus on providing definitions of the more commonly assessed constructs in neuro-oncology caregiver research, particularly where there might be overlap between related multidimensional constructs; evaluating the availability and psychometric properties of existing instruments linked to those constructs; and potentially, identifying needs for new instrument development.
Chair:
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