Abstract
Pseudoprogression refers to the initial apparent increase in tumor burden observed
on imaging after cancer therapy, with subsequent delayed response to the same treatment,
thus giving a false initial appearance of disease progression. It is essential to
differentiate pseudoprogression from true progression to prevent the patients from
getting deprived of the benefits of their ongoing cancer therapy owing to their early
withdrawal. It also affects their recruitment for clinical trials. Pseudoprogression,
albeit uncommon, has been observed after various types of cancer therapy; however,
this phenomenon has gained momentum of late due to the emergence of immunotherapy
for the treatment of various malignancies. Besides immunotherapy, pseudoprogression
has predominantly been of concern in a few patients after radiation therapy for brain
tumors and metastasis, after molecular targeted therapy for a variety of tumors, and
after chemotherapy in metastatic bone lesions. This article reviews the available
data on imaging of pseudoprogression from various types of cancer therapies, highlighting
ways to suspect or identify it on imaging.
Keywords
pseudoprogression - immunotherapy - radiation therapy - targeted therapy
