# RANO criteria (brain tumour response)

Source: https://onco.cc/terms/rano-criteria/  
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## TL;DR

The RANO criteria are the rules for judging on MRI whether a glioma is responding, stable or growing, and they allow for the false growth that radiotherapy can cause in the first months.

## Summary

The Macdonald criteria measured only the contrast-enhancing part of a brain tumour. After chemoradiotherapy for glioblastoma, 20 to 30% of patients show a transient increase in enhancement (pseudoprogression), and antiangiogenic drugs reduce enhancement without a true antitumour effect. The Response Assessment in Neuro-Oncology working group proposed updated criteria for high-grade gliomas (Wen and colleagues, Journal of Clinical Oncology 2010) that also assess the non-enhancing tumour.

RANO 2.0 (Wen and colleagues, Journal of Clinical Oncology 2023) uses one set of criteria for high- and low-grade gliomas whatever the treatment. In newly diagnosed disease the scan after radiotherapy, not after surgery, is the baseline, and in the 12 weeks after radiotherapy progression needs a confirming MRI or tissue proof. Two-dimensional measurement remains primary with volume optional, and for IDH wild-type glioblastoma the non-enhancing disease is no longer assessed except with antiangiogenic drugs.

## Fields

- Kind: Term
- Last checked: 2026-11-04
- Also known as: RANO; RANO criteria; RANO 2.0; RANO-HGG; RANO-LGG; mRANO; modified RANO; Response Assessment in Neuro-Oncology

## Sources

- Wen et al., Updated response assessment criteria for high-grade gliomas: Response Assessment in Neuro-Oncology working group (J Clin Oncol 2010): https://doi.org/10.1200/JCO.2009.26.3541
- Wen et al., RANO 2.0: update to the Response Assessment in Neuro-Oncology criteria for high- and low-grade gliomas in adults (J Clin Oncol 2023): https://doi.org/10.1200/JCO.23.01059

## Connected records

- terms: [Extent of resection (RANO resect classes)](https://onco.cc/terms/extent-of-resection/), [iRANO (immunotherapy response in neuro-oncology)](https://onco.cc/terms/irano/), [RANO-BM (brain metastases response criteria)](https://onco.cc/terms/rano-bm/), [RAPNO (paediatric brain tumour response criteria)](https://onco.cc/terms/rapno/), [RECIST](https://onco.cc/terms/recist/)
- cancers: [Glioma & glioblastoma](https://onco.cc/cancers/glioblastoma/)
- technologies: [MRI](https://onco.cc/technologies/mri/)
- key papers: [RANO 2.0: Update to the Response Assessment in Neuro-Oncology Criteria for High- and Low-Grade Gliomas in Adults](https://onco.cc/key-papers/paper-andrew-lassman-j-clin-oncol-2023/)

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