Chaitra Badve, Abraham Nirappel, Simon Lo, Daniel A Orringer, Jeffrey J Olson
{"title":"神经外科医师大会系统评价和基于证据的成像在成人新诊断WHO II级弥漫性胶质瘤中的作用指南：更新。","authors":"Chaitra Badve, Abraham Nirappel, Simon Lo, Daniel A Orringer, Jeffrey J Olson","doi":"10.1007/s11060-025-05043-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Target population: </strong>Adult patients with suspected or histologically proven WHO Grade II diffuse glioma. QUESTION 1: In adult patients with suspected or histologically proven WHO Grade II diffuse glioma, do advanced MRI techniques using magnetic resonance spectroscopy, perfusion weighted imaging or diffusion weighted imaging provide superior assessment of tumor grade, margins, progression, treatment-related effects, and prognosis compared to standard neuroimaging?</p><p><strong>Recommendation: </strong>Level II: The use of diffusion imaging and dynamic susceptibility contrast (DSC), dynamic contrast enhancement (DCE) and arterial spin labeling (ASL) sequences are suggested to differentiate WHO Grade II diffuse glioma from higher grade gliomas when this is not accomplished by T2 weighted and pre- and post-gadolinium contrast enhanced T1 weighted imaging.</p><p><strong>Level iii: </strong>The use of diffusion and perfusion is suggested for obtaining information in genomics, prognosis, and post treatment monitoring when this information would be of value to the clinician and is not obtained through other methods.</p><p><strong>Level iii: </strong>The use of MR Spectroscopy is suggested to differentiate WHO Grade II diffuse glioma from higher grade gliomas when this is not accomplished by standard MRI, perfusion and diffusion techniques and when such information would be of value to the clinician. 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QUESTION 1: In adult patients with suspected or histologically proven WHO Grade II diffuse glioma, do advanced MRI techniques using magnetic resonance spectroscopy, perfusion weighted imaging or diffusion weighted imaging provide superior assessment of tumor grade, margins, progression, treatment-related effects, and prognosis compared to standard neuroimaging?</p><p><strong>Recommendation: </strong>Level II: The use of diffusion imaging and dynamic susceptibility contrast (DSC), dynamic contrast enhancement (DCE) and arterial spin labeling (ASL) sequences are suggested to differentiate WHO Grade II diffuse glioma from higher grade gliomas when this is not accomplished by T2 weighted and pre- and post-gadolinium contrast enhanced T1 weighted imaging.</p><p><strong>Level iii: </strong>The use of diffusion and perfusion is suggested for obtaining information in genomics, prognosis, and post treatment monitoring when this information would be of value to the clinician and is not obtained through other methods.</p><p><strong>Level iii: </strong>The use of MR Spectroscopy is suggested to differentiate WHO Grade II diffuse glioma from higher grade gliomas when this is not accomplished by standard MRI, perfusion and diffusion techniques and when such information would be of value to the clinician. 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Congress of neurological surgeons systematic review and evidence-based guidelines for the role of imaging in newly diagnosed WHO grade II diffuse glioma in adults: update.
Target population: Adult patients with suspected or histologically proven WHO Grade II diffuse glioma. QUESTION 1: In adult patients with suspected or histologically proven WHO Grade II diffuse glioma, do advanced MRI techniques using magnetic resonance spectroscopy, perfusion weighted imaging or diffusion weighted imaging provide superior assessment of tumor grade, margins, progression, treatment-related effects, and prognosis compared to standard neuroimaging?
Recommendation: Level II: The use of diffusion imaging and dynamic susceptibility contrast (DSC), dynamic contrast enhancement (DCE) and arterial spin labeling (ASL) sequences are suggested to differentiate WHO Grade II diffuse glioma from higher grade gliomas when this is not accomplished by T2 weighted and pre- and post-gadolinium contrast enhanced T1 weighted imaging.
Level iii: The use of diffusion and perfusion is suggested for obtaining information in genomics, prognosis, and post treatment monitoring when this information would be of value to the clinician and is not obtained through other methods.
Level iii: The use of MR Spectroscopy is suggested to differentiate WHO Grade II diffuse glioma from higher grade gliomas when this is not accomplished by standard MRI, perfusion and diffusion techniques and when such information would be of value to the clinician. QUESTION 2: In adult patients with suspected or histologically proven WHO Grade II diffuse glioma, does molecular imaging using amino acid PET tracers provide superior assessment of tumor grade, margins, progression, treatment-related effects, and prognosis compared to standard neuroimaging?
Recommendation: Level III: If not already evident by MRI studies, the addition of amino acid PET with FET and FDOPA as a tracer is suggested to help determine if a brain lesion is a low grade glioma or high grade glioma.
Level iii: If the standard clinical prognostic parameters are unclear and novel PET tracers are available, the clinician may consider FET to assist in determination of prognosis in an individual with grade II diffuse glioma.
Level iii: Clinicians may use FDOPA PET in addition to MRI if additional information is required for detection of tumor progression.
期刊介绍：
The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.
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