The management of low-grade glioma (LGG) is shifting as evidence has emergedthat refutes the previously commonplace imaging-based ‘watch and wait’ approach, in favour of early aggressive surgical resection. This coupled with the recent 2016 update to the World Health Organisation Classification of Tumours of the Central Nervous System is changing LGG imaging and management. Recently in Practical Neurology the contemporary management of low-grade glioma and the changes to this grading system were discussed in detail.1 In this complementary article, we discuss the role of imaging in the diagnosis, surgical planning and post-treatment follow-up of LGG. We describe the principles of imaging these tumours and use several cases to highlight some difficult scenarios.
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Contributors JL wrote the initial manuscript. FMM conceived the idea for publication, provided the case vignettes and edited the manuscript. NH provided the images, provided the neuro-imaging text and reviewed the manuscript.
Competing interests None declared.
Provenance and peer review Commissioned. Externally peer reviewed. This paper was reviewed by Josh Klein, Boston, USA and Jeremy Rees, London, UK.