Glioneuronal Tumors: A Pictorial Review and Practical Approach

Abstract Many radiologists struggle to parse between glioneuronal tumors due to significant overlap in imaging, histology, and long-term behavior. However, most glioneuronal tumors have long, primarily benign courses, and therefore, it is not uncommon for imaging to be the primary source for clinical decision-making. In cases requiring resection, imaging features can inform preoperative risk and determine the need for adjuvant therapies. While these tumors are diagnostically challenging, specific imaging features have stronger diagnostic and prognostic associations. This review aims to provide an approach to navigating the glioneuronal tumor differential for practicing radiologists and radiology trainees. Through a set of representative cases, key imaging features are discussed that inform specific glioneuronal tumor diagnoses as well as subsequent clinical management.