The 2021 World Health Organization classification of CNS tumours was greeted with enthusiasm as well as an initial potential overwhelm. However, with time and experience, our understanding of its key aspects has notably improved. Using our collective expertise gained in neuro-oncology units in hospitals in different countries, we have compiled a practical guide for radiologists that clarifies the classification criteria for diffuse gliomas in adults. Its format is clear and concise to facilitate its incorporation into everyday clinical practice. The document includes a historical overview of the classifications and highlights the most important recent additions. It describes the main types in detail with an emphasis on their appearance on imaging. The authors also address the most debated issues in recent years. It will better prepare radiologists to conduct accurate presurgical diagnoses and collaborate effectively in clinical decision making, thus impacting decisions on treatment, prognosis, and overall patient care.
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http://dx.doi.org/10.1016/j.rxeng.2024.03.002 | DOI Listing |
No Shinkei Geka
January 2025
Division of Neurosurgery, Tohoku Medical and Pharmaceutical University.
This study reviews the diagnostic criteria and treatment strategies for spinal malignant gliomas, particularly glioblastoma with -wildtype and diffuse midline gliomas with H3-K27 alteration, according to the World Health Organization 2021 classification. Surgical resection remains challenging owing to the diffuse nature of these tumors. Even with the Stupp regimen(temozolomide and radiotherapy), the prognosis remains poor, with an average survival of 12 months.
View Article and Find Full Text PDFNeurol Neuroimmunol Neuroinflamm
March 2025
Department of Neurology and Experimental Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin.
Background And Objectives: Cognitive deficits represent a major long-term complication of anti-leucine-rich, glioma-inactivated 1 encephalitis (LGI1-E). Although severely affecting patient outcomes, the structural brain changes underlying these deficits remain poorly understood. In this study, we hypothesized a link between white matter (WM) networks and cognitive outcomes in LGI1-E.
View Article and Find Full Text PDFNeurosurgery
January 2025
Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Background And Objectives: Understanding and managing seizure activity is crucial in neuro-oncology, especially for highly epileptogenic lesions like isocitrate dehydrogenase (IDH)-mutant gliomas. Advanced MRI techniques such as diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) have been used to describe microstructural changes associated with epilepsy. However, their role in tumor-related epilepsy (TRE) remains unclear.
View Article and Find Full Text PDFNeurosurgery
January 2025
Service de Neurochirurgie, GHU-Paris Psychiatrie et Neurosciences, Paris, France.
Background And Objectives: The risk-to-benefit ratio of transopercular awake resection for recurrent insular diffuse gliomas is poorly studied. We assessed feasibility, safety, and efficacy of awake surgical resection of recurrent insular diffuse gliomas in patients with previous treatments (resection and/or radiotherapy and/or chemotherapy and/or combination).
Methods: Observational, retrospective, single-institution cohort analysis (2010-2023) of 123 consecutive adult patients operated on for an insular diffuse glioma (2021 World Health Organization classification) under awake conditions.
Comput Biol Med
January 2025
Institute of Biomedical Engineering, Bogazici University, Istanbul, Turkey; Center for Neuroradiological Applications and Research, Acibadem University, Istanbul, Turkey.
Background: Preoperative and noninvasive detection of isocitrate dehydrogenase (IDH) and telomerase reverse transcriptase gene promoter (TERTp) mutations in glioma is critical for prognosis and treatment planning. This study aims to develop deep learning classifiers to identify IDH and TERTp mutations using proton magnetic resonance spectroscopy (H-MRS) and a one-dimensional convolutional neural network (1D-CNN) architecture.
Methods: This study included H-MRS data from 225 adult patients with hemispheric diffuse glioma (117 IDH mutants and 108 IDH wild-type; 99 TERTp mutants and 100 TERTp wild-type).
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