Advances in diffuse glial tumors diagnosis.

Area of Science:

• Neuro-oncology
• Pathology
• Radiology

Background:

• Diffuse gliomas require precise diagnosis for effective treatment.
• Recent technological integration has significantly advanced understanding of glioma biology and classification.
• The 2021 fifth edition of the WHO classification of CNS tumors reflects these diagnostic improvements.

Approach:

• This review explores diagnostic advancements within a multidisciplinary framework, focusing on the latest WHO classification.
• It examines morphologic pathology, molecular/genetic techniques (immunohistochemistry, genetic sequencing, methylation profiling), and their correlation with neuroimaging radiophenotypes.
• The review also covers the utility of tractography, functional neuroimaging, perfusion MRI, spectroscopy, and nuclear medicine for surgical planning and distinguishing tumor progression from treatment effects.

Key Points:

• Morphologic pathology and molecular/genetic techniques are pivotal for accurate diffuse glioma diagnosis.
• Correlation between neuroimaging radiophenotypes and glioma pathology/genetics is crucial.
• Advanced imaging techniques aid in surgical planning and differentiating tumor progression from treatment-related changes.
• Emerging technologies like AI, radiomics, and radiogenomics show promise for future glioma diagnosis.

Conclusions:

• Evolving diagnostic techniques offer advantages but also face limitations in availability and utilization.
• Multidisciplinary collaboration is essential for translating diagnostic advancements into improved patient survival and quality of life for glioma patients.
• The integration of novel technologies promises to revolutionize diffuse glioma diagnosis and management.