Case-Based and Algorithmic Approach to Intra-Axial Brain Tumors with 2021 WHO Classification Updates

Document Type

Conference Proceeding

Publication Date



The purpose of this educational exhibit is to provide a framework for approaching intra-axial brain tumors in the adult and pediatric populations through a guided case-based format. There will also be an emphasis on integrating the WHO 2021 classification update where appropriate.

Educational Goals / Teaching Points
The goal of this educational exhibit is to first present an overview of an algorithmic approach to apply when presented with a brain tumor on imaging. The algorithm includes determining if the tumor is intra or extra-axial, narrowing a differential diagnosis based on patient age, tumor location, and characteristic features, and determining the aggressiveness of a tumor and tumor grading based on imaging features. The second goal is to use this approach and apply it to case examples of each brain tumor type. This will allow the viewer to test their background knowledge as well as the algorithmic approach presented to them at the beginning of the presentation. Each case will be accompanied by a tailored differential diagnosis, a pathology proven diagnosis, molecular markers where available, and a summary slide highlighting key features of each tumor. The summary slide will also integrate updates from the WHO 2021 classification. Lastly, the viewer will be shown a roadmap which includes all the cases/tumors presented and how they fit in with the algorithm, which will help solidify the former two mentioned educational goals.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The key pathophysiologic and imaging issues to be addressed are how the WHO 2016 molecular marker expansion, the very recent 2021 update of brain tumors correlates with existing imaging tumor archetypes, and what changes a radiologist must be aware of. Literature will be surveyed until the time of presentation to determine if new advances have been made in specific imaging manifestation for new entities from the WHO 2021 classification update.

In conclusion, this educational exhibit will showcase, through an algorithmic and case-based approach, the current gamut of intra-axial brain tumors in the adult and pediatric populations, with specific emphasis on the recent WHO brain tumor updates.