Open Access

Christian Franz Freyschlag, Sandro Krieg, Johannes Kerschbaumer, Daniel Pinggera, Marie-Thérèse Forster, Dominik Cordier, Marco Rossi, Gabriele Miceli, Alexandre Roux, Andrés Reyes, Silvio Sarubbo, Anja Smits, Joanna Sierpowska, Pierre A. Robe, Geert‑Jan Rutten, Thomas Santarius, Tomasz Matys, Marc Zanello, Fabien Almairac, Lydiane Mondot, Asgeir Store Jakola, Maria Zetterling, Adrià Rofes, Gord von Campe, Remy Guillevin, Daniele Bagatto, Vincent Lubrano, Marion Rapp, John Goodden, Philip C. de Witt Hamer, Johan Pallud, Lorenzo Bello, Claudius Thomé, Hugues Duffau, Emmanuel Mandonnet

• Objective: Imaging studies in diffuse low-grade gliomas (DLGG) vary across centers. In order to establish a minimal core of imaging necessary for further investigations and clinical trials in the field of DLGG, we aimed to establish the status quo within specialized European centers. Methods: An online survey composed of 46 items was sent out to members of the European Low-Grade Glioma Network, the European Association of Neurosurgical Societies, the German Society of Neurosurgery and the Austrian Society of Neurosurgery. Results: A total of 128 fully completed surveys were received and analyzed. Most centers (n = 96, 75%) were academic and half of the centers (n = 64, 50%) adhered to a dedicated treatment program for DLGG. There were national differences regarding the sequences enclosed in MRI imaging and use of PET, however most included T1 (without and with contrast, 100%), T2 (100%) and TIRM or FLAIR (20, 98%). DWI is performed by 80% of centers and 61% of centers regularly performed PWI. Conclusion: A minimal core of imaging composed of T1 (w/wo contrast), T2, TIRM/FLAIR, PWI and DWI could be identified. All morphologic images should be obtained in a slice thickness of ≤ 3 mm. No common standard could be obtained regarding advanced MRI protocols and PET. Importance of the study: We believe that our study makes a significant contribution to the literature because we were able to determine similarities in numerous aspects of LGG imaging. Using the proposed "minimal core of imaging" in clinical routine will facilitate future cooperative studies.