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Free Content A Comprehensive Clinical Review of Adult-Type Diffuse Glioma Incorporating the 2021 World Health Organization Classification

The intent of this article is to provide a comprehensive, educational review of adult-type diffuse gliomas, bringing together the role of the multidisciplinary team and giving the reader biologic, surgical, radiologic, and oncologic insight into these tumors. The reader will be guided through subsections that explain the molecular pathophysiology, diagnosis, treatment, prognosis and natural history of the disease. The 2021 World Health Organization Classification will be explained through a combination of concise historic review of glioma diagnosis and contemporary knowledge of the molecular pathways. Accompanying illustrations will act as powerful tools for comprehension. These concepts will be underpinned by frequent reference to neuroradiology and a grounding of normal brain composition.

Learning Objective: To understand the pathophysiologic concepts that underly the World Health Organization Classification and natural history of adult-type diffuse gliomas and how these relate to imaging and treatment strategies

Keywords: AKT= AK strain transforming (known as protein kinase B); ALT = alternative lengthening of telomeres; ATP = adenosine triphosphate; BTB = blood-tumor barrier; CDK = cyclin-dependent kinase; ECM = extracellular matrix; EGF = epidermal growth factor; EGFR = epidermal growth factor receptor; GBM = glioblastoma; GSC = glioma stem cells; HG = hydroxyglutarate; HGG = high-grade glioma; IDH = isocitrate dehydrogenase; IDHm = IDH mutation; IDHwt = IDH wild type; ISF = interstitial fluid; ISS = interstitial system; LGG = low-grade glioma; MDM2 = mouse double minute 2 homolog; MGMT = methyltransferase; NSC = neural stem cell; OS = overall survival; PDGFR = platelet derived growth factor receptor; PI3K = phosphoinositide 3-kinase; PTEN = phosphatase and tensin homolog; RTK = receptor tyrosine kinase; Raf = rapidly accelerated fibrosarcoma, a signaling protein; Ras = rat sarcoma virus, a signaling protein; T1Gd = intravenous gadolinium contrast administration; TCGA = The Cancer Genome Atlas; TME = tumor microenvironment; TMZ = temozolomide; VEGF = vascular endothelial growth factor; WHO = World Health Organization; cIMPACT = Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy; mTOR = mammalian/mechanistic target of rapamycin; pRB = retinoblastoma protein

Document Type: Research Article

Publication date: April 1, 2022

More about this publication?
  • Neurographics is the peer-reviewed, quarterly educational journal of the American Society of Neuroradiology. The journal includes review articles as well as high-yield case reports that have been solicited from society meetings including the annual ASNR meeting as well as the American Society of Spine Radiology, the American Society of Pediatric Neuroradiology, the American Society of Functional Neuroradiology, and the American Society of Head and Neck Radiology meetings. Unsolicited educational review articles and case reports are also accepted for review at the discretion of the Editor-in-Chief. Submissions focusing on a pictorial approach to educational objectives are highly encouraged. The journal is open access and available online. CME credit is offered for reading review articles and completing quiz-based self-assessment activities through the ASNR Education Connection portal.

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