Radiological classification of optic pathway gliomas: experience of a modified functional classification system.
Optic pathway gliomas (OPGs) in childhood are associated with neurofibromatosis type 1 (NF1) and since 1958 have been classified anatomically using the Dodge classification (DC). MR scanning permits a more detailed anatomical description than can be classified by this historical system. A modified Dodge classification (MDC) has been applied to MRI scans from a cohort of 72 patients (36.1% NF1-positive) from 4 centres participating in an international clinical trial. The MDC was feasible, applicable and more detailed than the original DC. NF1-positive cases more commonly involved both optic nerves (p = 0.021) and other multiple locations (p = 0.001). NF1-negative tumours more commonly involved the central chiasm (p = 0.005) and hypothalamus (p = 0.003). Fewer hypothalamus-positive tumours were associated with optic nerve involvement (p = 0.009), whereas more were associated with central chiasm involvement (p<0.001). From diagnosis to follow-up, there was concordance between DC and MDC in 51/72 cases (70.8%). The MDC is therefore proposed for use in clinical trials of new treatments for OPGs.
Taylor
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T
Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK.
Jaspan
T
T
Milano
G
G
Gregson
R
R
Parker
T
T
Ritzmann
T
T
Benson
C
C
Walker
D
D
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007029:Hypothalamic Neoplasms / Q000145:classification* / Q000175:diagnosis; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009456:Neurofibromatosis 1 / Q000150:complications; D020339:Optic Nerve Glioma / Q000145:classification* / Q000175:diagnosis; D019574:Optic Nerve Neoplasms / Q000145:classification* / Q000175:diagnosis; D010865:Pilot Projects; D011379:Prognosis; D016896:Treatment Outcome