RANO 2.0
Response Assessment in Neuro-Oncology (Gliomas)
RANO defines how treatment response is judged in glioma trials, and RANO 2.0 unifies a decade of fragmented criteria into one framework for both high- and low-grade tumors across treatment types. Key changes: the post-radiotherapy scan (not the post-surgical scan) becomes the newly-diagnosed baseline; a standardized brain-tumor imaging protocol is adopted; T2/FLAIR measurements are dropped from enhancing-tumor assessment; and confirmation scans formalize how preliminary progression is handled — all aimed at the pseudoprogression and pseudoresponse that plague glioma follow-up. Increasingly the language radiologists must use when reading brain-tumor trials.
Version history & what changed
- RANO 2.02023Current
Unifies high- and low-grade criteria into one framework: post-radiotherapy scan as the newly-diagnosed baseline, a standardized imaging protocol, T2/FLAIR dropped from enhancing-tumor assessment, and confirmation scans for preliminary progression — targeting pseudoprogression and pseudoresponse.
- mRANO / iRANO2017
Modified RANO (single bidimensional measurement, cleaner baseline handling) and immunotherapy RANO, which added rules for delayed treatment responses.
- RANO-HGG / RANO-LGG2010
The original criteria: added non-enhancing/T2 assessment plus corticosteroid dose and clinical status to response, moving beyond the older Macdonald criteria to address pseudoprogression.
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Resources & links
- referenceRANO 2.0 (J Clin Oncol 2023)
RadPigeon is an independent radiology news digest and is not affiliated with or endorsed by RANO Working Group. “RANO 2.0” is a trademark of its owner and is named here only to refer to the system. Always consult the official source for the exact, current criteria.

