Abstract

The inclusion of molecular and genetic information, along with histopathology, now defines the framework for brain tumor classification and grading. This framework is reflected in the major restructuring of the WHO brain tumor classification system in 2016, as well as in numerous subsequent proposed updates reflecting ongoing developments in understanding of the impact of tumor genotype on classification and grading. This incorporation of molecular and genetic features allows for improved tumor diagnosis and prediction of tumor behavior and response to treatment. Neuroimaging is essential for the noninvasive assessment of pre-treatment tumor grading and identification and determination of therapeutic efficacy. Conventional neuroimaging as well as physiologic imaging techniques such as diffusion- and perfusion- weighted MRI can increase the diagnostic confidence in the pre-treatment and post-treatment settings. While the use of neuroimaging to consistently determine tumor genetics is not yet robust, promising developments are on the horizon. Given the complexity of the brain tumor microenvironment, the development and implementation of a standardized reporting system can aid in conveying important information about brain tumor response to treatment to radiologists, referring providers, and patients. This article reviews the current state and role of neuroimaging in this continuously evolving field.

View details for DOI 10.2214/AJR.20.25246

View details for PubMedID 33502214