Podoplanin expression is associated with local inflammation and survival in glioma.

Glioma subtypes differ in prognosis and treatment strategies. We aimed to determine the correlation of podoplanin (PDPN) expression in glioma subtypes with survival as well as systemic and local inflammation. In a prospective cohort study including 192 patients with glioma, tumor-infiltrating lymphocytes (TILs), programmed cell death ligand 1 (PD-L1) expression and podoplanin (PDPN) expression were analyzed by immunohistochemistry.

Prognostic stratification of newly diagnosed IDH-mutant gliomas by [18F]fluoroethyltyrosine and [11C]methionine PET - a retrospective, bicentric cohort study.

Background: Improved prognostic stratification including imaging-based parameters is needed to guide treatment decisions in IDH-mutant glioma.

Methods: In this bicentric retrospective study, 457 patients with IDH-mutant glioma and [18F]fluoroethyltyrosine or [11C]methionine positron emission tomography (PET) prior to radiotherapy or systemic treatment were included. Associations of maximum and mean tumor-to-background ratios (TBRmax/TBRmean) and PET-positive volume (PET volume) with time to next intervention (TTNI) and overall survival (OS) were analyzed.

Estimating overall survival of glioblastoma patients using clinical variables, tumor size, and location.

Background: Accurate prognosis of glioblastoma is crucial for better-informed treatment decisions, potentially leading to improved disease management. We investigated whether clinical variables, tumor size, and location, can serve as prognostic factors.

Methods: A retrospective, multicenter study enrolled 1318 adult patients with histopathologically confirmed glioblastoma undergoing first-time surgery, with survival censored for 188 patients.

Personalized targeted glioblastoma therapies by ex vivo drug screening: Study protocol of the Advanced brain Tumor TheRApy Clinical Trial (ATTRACT).

Background: Novel approaches to guide personalized treatment in glioblastoma are urgently needed. Given the poor predictive value of genetic biomarkers in glioblastoma, we are conducting a prospective clinical trial to investigate the novel approach of cultivated patient-derived tumor cells (PDCs) for ex vivo drug screening.

Methods: In this randomized phase 2 study, we are testing the ability of PDC-based ex vivo drug screening to formulate a personalized recommendation for maintenance treatment in patients with newly diagnosed glioblastoma with unmethylated MGMT promoter after combined radio-chemotherapy.

Alzheimer's disease neuropathological change in younger individuals with IDH-mutant glioma.

Background: With aging populations, the incidence of brain tumors and neurodegenerative diseases is rising. Recently, Alzheimer's disease neuropathological change (ADNC) has been documented in the tumor-adjacent cortex of 50% of patients with glioblastoma, with isolated hyperphosphorylated tau (pTau) deposits already present in younger individuals. This study extends ADNC screening to younger patients with IDH-mutant glioma, focusing on pTau and amyloid beta (Abeta) deposits, microglial activation, and amyloid precursor protein (APP) expression in the context of cortical tumor cell infiltration.

Prognostic relevance of the neurological symptom burden in brain metastases from breast cancer.

Background: Existing prognostic models for breast cancer (BC) brain metastases (BM) overlook neurological symptoms. Thus, we explored the incidence and prognostic relevance of neurological symptoms in a real-world cohort of BC patients with BM.

Methods: The Vienna Brain Metastasis Registry identified BC patients with BM between 1992 and 2020, categorised by subtype: hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-), HER2 overexpressing (HER2+), and triple-negative (TN).

Expression of SSTR2a, FAP, HER2 and HER3 as potential radionuclide therapy targets in higher-grade meningioma.

Purpose: High-grade meningiomas have high recurrence rates and limited prognosis. Radioligand therapies are approved in extracranial malignancies, but their value in brain tumours including meningiomas is unclear, as data on target expression is scarce.

Methods: CNS WHO grade 2 and 3 meningioma samples were immunohistochemically stained for somatostatin receptor 2a (SSTR2a), fibroblast activation protein (FAP), and human epidermal growth factor receptors 2/3 (HER2/HER3).

Association of pregnancy with tumour progression in patients with glioma.

Background: A significant proportion of women in reproductive age are diagnosed with diffuse gliomas, resulting in the need to address the safety of pregnancy in patient consultation. However, data on glioma progression after and during pregnancy are sparse and controversial.

Methods: Female adult patients in their reproductive years (≥18 years and <46 years) with histological diagnosis of glioma between 01/01/2000 and 01/12/2019 from 2 academic centers have been included in the study.

Clinical characteristics, molecular reclassification trajectories and DNA methylation patterns of long- and short-term survivors of WHO grade II and III glioma.

Purpose: The prognosis of diffuse gliomas previously classified as "lower-grade" is heterogeneous and complicates clinical decisions. We aimed to investigate the molecular profile of clinical outliers to gain insight into biological drivers of long and short-term survivors.

Methods: Here, patients aged ≥ 18 years and diagnosed with diffuse glioma, WHO grade II/2 or III/3 were included.

Sex-specific differences in DNA methylation defining prognostically relevant subgroups in glioblastoma.

Objective: Glioblastoma is an aggressive brain tumor that is more common and has a worse outcome in males. Recently, the observed sex differences have been linked to tumor biology, prominently highlighting fundamental differences in gene expression programs. Here, the authors advance this concept to epigenome-based DNA methylation patterns across primary and recurring glioblastoma.

Prognostic value of manual versus automatic methods for assessing extents of resection and residual tumor volume in glioblastoma.

Objective: The extent of resection (EOR) and postoperative residual tumor (RT) volume are prognostic factors in glioblastoma. Calculations of EOR and RT rely on accurate tumor segmentations. Raidionics is an open-access software that enables automatic segmentation of preoperative and early postoperative glioblastoma using pretrained deep learning models.

Detection of H3F3A K27M or BRAF V600E in liquid biopsies of brain tumor patients as diagnostic and monitoring biomarker: impact of tumor localization and sampling method.

Gliomas are the most common brain tumor type in children and adolescents. To date, diagnosis and therapy monitoring for these tumors rely on magnetic resonance imaging (MRI) and histopathological as well as molecular analyses of tumor tissue. Recently, liquid biopsies (LB) have emerged as promising tool for diagnosis and longitudinal tumor assessment potentially allowing for a more precise therapeutic management.

Addressing the role of surgery in brain tumour trials: A report from the neurosurgery committee of the EORTC brain tumour group.

The Brain Tumor Group (BTG) of the European Organization for Research and Treatment of Cancer (EORTC) conducts academic clinical trials and translational research to improve clinical management of patients with primary and secondary brain tumors. The EORTC BTG has traditionally played an important role in providing evidence and thus advancing the field, albeit with a main focus on radiotherapy and pharmacotherapy in gliomas. Although examples of well-designed neuro-oncological surgical trials can be found, evidence in surgical neuro-oncology predominantly includes data from uncontrolled prospective series or retrospective cohorts.

Analysis of the Porphyrin Peak Shift and Fluorescence Lifetime in Gliomas with Different Tumor Grades, Intratumoral Regions, and Visible Fluorescence Status.

5-aminolevulinic acid (5-ALA)-induced protoporphyrin IX (PpIX) fluorescence shows high sensitivity in detecting the tumor core of high-grade gliomas (HGG) but poor sensitivity for tissue of low-grade gliomas (LGG) and the margins of HGG. The characteristic emission peak for PpIX is known to be located at 635 nm. Recently, a second emission peak was described at 620 nm wavelength in LGG and the tumor infiltration zone of HGG.

Clinical application of machine-based deep learning in patients with radiologically presumed adult-type diffuse glioma grades 2 or 3.

Background: Radiologically presumed diffuse lower-grade glioma (dLGG) are typically non or minimal enhancing tumors, with hyperintensity in T2w-images. The aim of this study was to test the clinical usefulness of deep learning (DL) in mutation prediction in patients with radiologically presumed dLGG.

Methods: Three hundred and fourteen patients were retrospectively recruited from 6 neurosurgical departments in Sweden, Norway, France, Austria, and the United States.

Towards integrating imaging and immunology in glioblastoma: mapping blood immune system metrics to tumor magnetic resonance image data.

Background: Glioblastoma is the most frequent and aggressive brain cancer. It is a highly immunology-driven disease as up to a third of its mass is composed of immune cells. Apart from immunology, imaging is a major research frontier.

Foundation models for fast, label-free detection of glioma infiltration.

A critical challenge in glioma treatment is detecting tumour infiltration during surgery to achieve safe maximal resection. Unfortunately, safely resectable residual tumour is found in the majority of patients with glioma after surgery, causing early recurrence and decreased survival. Here we present FastGlioma, a visual foundation model for fast (<10 s) and accurate detection of glioma infiltration in fresh, unprocessed surgical tissue.

A Flow-based Truncated Denoising Diffusion Model for super-resolution Magnetic Resonance Spectroscopic Imaging.

Magnetic Resonance Spectroscopic Imaging (MRSI) is a non-invasive imaging technique for studying metabolism and has become a crucial tool for understanding neurological diseases, cancers and diabetes. High spatial resolution MRSI is needed to characterize lesions, but in practice MRSI is acquired at low resolution due to time and sensitivity restrictions caused by the low metabolite concentrations. Therefore, there is an imperative need for a post-processing approach to generate high-resolution MRSI from low-resolution data that can be acquired fast and with high sensitivity.

Frequent Alzheimer's disease neuropathological change in patients with glioblastoma.

Background: The incidence of brain cancer and neurodegenerative diseases is increasing with a demographic shift towards aging populations. Biological parallels have been observed between glioblastoma and Alzheimer's disease (AD), which converge on accelerated brain aging. Here, we aimed to map the cooccurrence of AD neuropathological change (ADNC) in the tumor-adjacent cortex of patients with glioblastoma.

Glioblastoma in the real-world setting: patterns of care and outcome in the Austrian population.

Purpose: We present results of a retrospective population-based investigation of patterns of care and outcome of glioblastoma patients in Austria.

Patients And Methods: In this nation-wide cooperative project, all Austrian glioblastoma patients newly diagnosed between 2014 and 2018 and registered in the ABTR-SANOnet database were included. Histological typing used criteria of the WHO classification of CNS tumors, 4th edition 2016.

Localization of protoporphyrin IX during glioma-resection surgery via paired stimulated Raman histology and fluorescence microscopy.

The most widely used fluorophore in glioma-resection surgery, 5-aminolevulinic acid (5-ALA), is thought to cause the selective accumulation of fluorescent protoporphyrin IX (PpIX) in tumour cells. Here we show that the clinical detection of PpIX can be improved via a microscope that performs paired stimulated Raman histology and two-photon excitation fluorescence microscopy (TPEF). We validated the technique in fresh tumour specimens from 115 patients with high-grade gliomas across four medical institutions.