The 2021 WHO Classification for Gliomas and Implications on Imaging Diagnosis: Part 1-Key Points of the Fifth Edition and Summary of Imaging Findings on Adult-Type Diffuse Gliomas

Abstract

The fifth edition of the World Health Organization (WHO) classification of central nervous system tumors published in 2021 advances the role of molecular diagnostics in the classification of gliomas by emphasizing integrated diagnoses based on histopathology and molecular information and grouping tumors based on genetic alterations. Importantly, molecular biomarkers that provide important prognostic information are now a parameter for establishing tumor grades in gliomas. Understanding the 2021 WHO classification is crucial for radiologists for daily imaging interpretation as well as communication with clinicians. Although imaging features are not included in the 2021 WHO classification, imaging can serve as a powerful tool to impact the clinical practice not only prior to tissue confirmation but beyond. This review represents the first of a three-installment review series on the 2021 WHO classification for gliomas, glioneuronal tumors, and neuronal tumors and implications on imaging diagnosis. This Part 1 Review focuses on the major changes to the classification of gliomas and imaging findings on adult-type diffuse gliomas. EVIDENCE LEVEL: 3. TECHNICAL EFFICACY: Stage 3.

Keywords: World Health Organization; central nervous system neoplasms; glioma; magnetic resonance imaging.