Radiological classification of optic pathway gliomas: experience of a modified functional classification system.

Area of Science:

• Pediatric Oncology
• Neuro-oncology
• Medical Imaging

Background:

• Childhood optic pathway gliomas (OPGs) are often linked to neurofibromatosis type 1 (NF1).
• The historical Dodge classification (DC) for OPGs has limitations with modern imaging techniques.
• Accurate anatomical classification is crucial for treatment and research in OPGs.

Purpose of the Study:

• To evaluate the feasibility and detail of a modified Dodge classification (MDC) for OPGs using MRI.
• To compare the MDC with the traditional DC in a cohort of pediatric OPG patients.
• To identify differences in tumor location based on NF1 status using the MDC.

Main Methods:

• A modified Dodge classification (MDC) was applied to MRI scans of 72 pediatric OPG patients.
• Patients were recruited from four centers participating in an international clinical trial.
• Tumor locations were analyzed and compared between NF1-positive and NF1-negative groups.

Main Results:

• The MDC proved feasible, applicable, and provided more detailed anatomical descriptions than the DC.
• NF1-positive OPGs more frequently involved both optic nerves and multiple locations.
• NF1-negative OPGs were more commonly found in the central chiasm and hypothalamus.
• Concordance between DC and MDC was observed in 70.8% of cases.

Conclusions:

• The modified Dodge classification (MDC) is a superior system for detailed anatomical assessment of OPGs via MRI.
• The MDC effectively differentiates tumor characteristics between NF1-positive and NF1-negative pediatric patients.
• The MDC is recommended for use in future clinical trials for OPG treatments.