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British Journal of Radiology (2008) 81, 761-766
© 2008 British Institute of Radiology
doi: 10.1259/bjr/65246351
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British Journal of Radiology 81 (2008),761-766 ©2008 The British Institute of Radiology

Full paper

Radiological classification of optic pathway gliomas: experience of a modified functional classification system

T TAYLOR, MBChB, MRCP, FRCR 1 T JASPAN, BSc, FRCR, FRCP 1 G MILANO, MD, PhD 2 R GREGSON, FRCS, FRCOphth 1 T PARKER, BSc, PhD 3 T RITZMANN, BMedSci 3 C BENSON, BMedSci 3 D WALKER, BMedSci, BM BS, FRCP, FRCPCH 3 on behalf of the PLAN Study Group

1 Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham NG7 2UH, UK, 2 Ospedale Pediatrico Bambino Gesu, Rome 00165, Italy and 3 Children's Brain Tumour Research Centre (CBTR), University of Nottingham, Nottingham NG7 2UH, UK

Correspondence: David A Walker, Professor of Paediatric Oncology, Children's Brain Tumour Research Centre, University of Nottingham, Nottingham NG7 2UH, UK. E-mail: David.Walker{at}nottingham.ac.uk

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.




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