From the Division of Neuroradiology, Department of Radiology (R.K., M.K., A.B., Y.O., A.A.C., E.L., A.S., T.M.) and Department of Pathology (E.P., S.C.P.), Michigan Medicine, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109; and Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan (R.K., M.K.).
Radiographics. 2022 Sep-Oct;42(5):1474-1493. doi: 10.1148/rg.210236. Epub 2022 Jul 8.
The World Health Organization (WHO) published the fifth edition of the (WHO CNS5) in 2021, as an update of the WHO central nervous system (CNS) classification system published in 2016. WHO CNS5 was drafted on the basis of recommendations from the Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy (cIMPACT-NOW) and expounds the classification scheme of the previous edition, which emphasized the importance of genetic and molecular changes in the characteristics of CNS tumors. Multiple newly recognized tumor types, including those for which there is limited knowledge regarding neuroimaging features, are detailed in WHO CNS5. The authors describe the major changes introduced in WHO CNS5, including revisions to tumor nomenclature. For example, WHO grade IV tumors in the fourth edition are equivalent to CNS WHO grade 4 tumors in the fifth edition, and diffuse midline glioma, -mutant, is equivalent to midline glioma, -altered. With regard to tumor typing, isocitrate dehydrogenase (IDH)-mutant glioblastoma has been modified to -mutant astrocytoma. In tumor grading, -mutant astrocytomas are now graded according to the presence or absence of homozygous deletion. Moreover, the molecular mechanisms of tumorigenesis, as well as the clinical characteristics and imaging features of the tumor types newly recognized in WHO CNS5, are summarized. Given that WHO CNS5 has become the foundation for daily practice, radiologists need to be familiar with this new edition of the WHO CNS tumor classification system. and the are available for this article. RSNA, 2022.
世界卫生组织（WHO）于 2021 年发布了第五版《（WHO CNS5）》，作为 2016 年发布的 WHO 中枢神经系统（CNS）分类系统的更新版。WHO CNS5 是在 Consortium to Inform Molecular and Practical Approaches to CNS Tumor Taxonomy（cIMPACT-NOW）的建议基础上起草的，阐述了前一版的分类方案，该方案强调了中枢神经系统肿瘤遗传和分子变化的重要性。第五版详细介绍了多种新认可的肿瘤类型，包括那些在神经影像学特征方面知识有限的肿瘤类型。作者描述了 WHO CNS5 中引入的主要变化，包括肿瘤命名法的修订。例如，第四版的 WHO 四级肿瘤相当于第五版的 CNS WHO 四级肿瘤，弥漫性中线胶质瘤，-突变，相当于中线胶质瘤，-改变。关于肿瘤分型，异柠檬酸脱氢酶（IDH）-突变型胶质母细胞瘤已修改为 -突变型星形细胞瘤。在肿瘤分级中，-突变型星形细胞瘤现在根据是否存在纯合缺失进行分级。此外，还总结了肿瘤发生的分子机制，以及 WHO CNS5 中新认可的肿瘤类型的临床特征和影像学特征。鉴于 WHO CNS5 已成为日常实践的基础，放射科医生需要熟悉这个新的 WHO CNS 肿瘤分类系统。本文提供全文。RSNA，2022 年。
