Illuminating radiogenomic signatures in pediatric-type diffuse gliomas: insights into molecular, clinical, and imaging correlations. Part I: high-grade group.
Authors
Affiliations (15)
Affiliations (15)
- Department of Radiology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan. [email protected].
- Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan.
- Department of Artificial Intelligence, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
- Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
- Department of Radiology, Institute of Medicine, University of Tsukuba, Tsukuba, Japan.
- Department of Diagnostic Radiology, Kansai Electric Power Hospital, Osaka, Japan.
- Department of Radiation Oncology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
- Department of Diagnostic Imaging and Nuclear Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
- Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan.
- Department of Radiology, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
- Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
- Department of Radiology, University of Occupational and Environmental Health, School of Medicine, Kitakyushu, Japan.
- Department of Radiology, Kobe University Graduate School of Medicine, Hyogo, Japan.
- Department of Diagnostic Radiology, National Cancer Center Hospital, Tokyo, Japan.
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
Abstract
Recent advances in molecular genetics have revolutionized the classification of pediatric-type high-grade gliomas in the 2021 World Health Organization central nervous system tumor classification. This narrative review synthesizes current evidence on the following four tumor types: diffuse midline glioma, H3 K27-altered; diffuse hemispheric glioma, H3 G34-mutant; diffuse pediatric-type high-grade glioma, H3-wildtype and IDH-wildtype; and infant-type hemispheric glioma. We conducted a comprehensive literature search for articles published through January 2025. For each tumor type, we analyze characteristic clinical presentations, molecular alterations, conventional and advanced magnetic resonance imaging features, radiological-molecular correlations, and current therapeutic approaches. Emerging radiogenomic approaches utilizing artificial intelligence, including radiomics and deep learning, show promise in identifying imaging biomarkers that correlate with molecular features. This review highlights the importance of integrating radiological and molecular data for accurate diagnosis and treatment planning, while acknowledging limitations in current methodologies and the need for prospective validation in larger cohorts. Understanding these correlations is crucial for advancing personalized treatment strategies for these challenging tumors.