The 2016 World Health Organization Classification of Tumors of the Central Nervous System: A Practical Approach for Gliomas, Part 2. Isocitrate Dehydrogenase Status—Imaging Correlation

Central nervous system glial tumors are now classified based on their histologic appearance and their isocitrate dehydrogenase status. The last World Health Organization classification update, published in 2016, gives more importance to the genotype as a determinant of prognosis than to the histologic phenotype. The main difficulty is that the genetic study considered as the criterion standard can only be done after surgical intervention, once the tissue is available. This new approach brings a new challenge to radiologists, that is, to identify imaging features that lead to a given genotype at the initial diagnosis. This article reviewed the state of the art in the correlation between imaging and isocitrate dehydrogenase status, and provided representative illustrations.

Learning Objective: Describe the main MR findings in differentiating gliomas isocitrate dehydrogenase mutant versus isocitrate dehydrogenase wild type.