TRIA Diagnostic Framework: Confirmation Flowchart and MRI Request Form developed by the RING Consortium
The RING (Radiation Imaging and Neuro-Oncology) group conducted an international Delphi consensus to establish a standardized framework for describing MRI abnormalities following radiotherapy in patients with intracranial central nervous system (CNS) tumours. Current literature uses inconsistent terminology, including radiation necrosis, pseudoprogression, and treatment-related changes, without standardised definitions, which hinders communication and clinical decision-making, and limits comparability across studies.
Through a structured consensus process with participation from ESTRO, ESNR, EORTC, and EPTN members, and endorsement from these societies, the umbrella term Treatment-Related Imaging Abnormalities (TRIA) was adopted with high levels of agreement. To facilitate consistent implementation of the TRIA framework in clinical practice and research, a TRIA conformation flowchart and dedicated MRI Request Forms for standard and TRIA surveillance were developed.
By clicking on the button below, you can use the online flowchart dynamically on the site here. Furthermore, the TRIA diagnostic flowchart and MRI request form are available as downloads, designed to support standardized surveillance and promote consistent terminology and reporting across institutions and studies.
Please site this data publication as follows:
TRIA Diagnostic Framework: Confirmation Flowchart and MRI Request Form developed by the RING ConsortiumLieselotte Lauwens, Catharine M.L. Zegers, Alida A. Postma, Giuseppe Minniti, Martin J van den Bent,
Maarten Lambrecht, Marion Smits, Daniëlle B.P. Eekers, on behalf of the RING consortiumCancerData, 2025; doi:10.17195/candat.2026.02.1