儿童脑肿瘤免疫治疗的影像学评估

The aim of this review is to summarize current immunotherapeutic strategies for pediatric solid CNS tumors and to discuss their characteristic imaging findings and response patterns, with emphasis on pitfalls in differentiating true progression from treatment related inflammatory changes.

Across different immunotherapeutic approaches, a major challenge is distinguishing tumor progression from pseudoprogression, immune related flare phenomena, and neurotoxicity. Multiparametric imaging combining advanced MRI techniques and metabolic imaging may improve diagnostic specificity; however, validation in children is limited, and existing response frameworks such as iRANO and RAPNO do not specifically address immunotherapy related imaging patterns in the pediatric population.

Immunotherapy is reshaping the management of pediatric solid CNS tumors, but imaging based response assessment remains difficult. There is a pressing need for pediatric focused response criteria and standardized imaging strategies that incorporate the unique features of immunotherapy related changes in the developing brain.