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.

[Lu]Lu-DOTATATE for Recurrent Meningioma (LUMEN-1, EORTC-2334-BTG): Study Protocol for a Randomized Phase II Trial.

There are no established treatment options for patients with meningioma recurring after surgery and radiotherapy. Somatostatin receptor type 2 (SSTR2) is highly expressed in meningiomas, and SSTR2-targeting radionuclide therapy with [Lu]Lu-DOTATATE has shown potential activity in the treatment of meningioma in uncontrolled and small studies. EORTC-2334-BTG (LUMEN-1, NCT06326190) is a randomized, multicenter, phase II trial in patients with recurrent World Health Organization (WHO) grade 1, 2, or 3 meningioma.

The concept, intention, and evaluation of the term treatment-refractory meningioma.

Background: Treatment-refractory meningioma is a widely used term but lacks standardized criteria, impairing research comparability and treatment evaluation. The aim of this study was to assess the heterogeneity of patient populations labeled as treatment-refractory and to explore recommendations for better consistency.

Methods: We systematically reviewed 69 studies published before 2024 and analyzed individual participant data from 15 cohorts (n = 211) that included treatment-refractory patients who underwent experimental therapy with somatostatin receptor (SSTR)-targeted therapies.

Prognostic value of 1D, 2D, and volumetric tumor size increases in recurrent WHO grade 2 and 3 meningiomas: Radiological post-hoc analysis of the EORTC-BTG-1320 trial.

Background: Although the differential prognostic value of 1D, 2D, and volumetric meningioma size assessment has been reported, RANO meningioma criteria rely on bidimensional measurements.

Methods: In this post-hoc analysis of the EORTC-BTG 1320 trial, contrast-enhancing CNS WHO grade 2 and 3 meningiomas were assessed using 1D, 2D, and volumetric measurements. Different cutoff values for lesion size increase were compared 6 months after the start of antineoplastic treatment using Cox proportional hazards models to evaluate their association with overall survival (OS).

Predicting critical surgical characteristics of intracranial meningiomas on MRI-A prospective study on 100 consecutive patients.

Background: This study aimed to identify magnetic resonance imaging (MRI) markers predictive of essential surgical characteristics in meningiomas, including consistency, ease of dissection of meningioma from surrounding brain tissue, and vascularity, which are crucial for surgical decisions and outcomes.

Methods: We conducted preoperative MRI using a standardized protocol to measure signal intensities (SI) within meningiomas. Additionally, we administered intraoperative questionnaires and performed histological analyses on each tumor.

Availability and use of PET in patients with brain tumours - a European Organisation for Research and Treatment of Cancer - Brain Tumour Group (EORTC-BTG) survey.

Purpose: Positron emission tomography (PET) is increasingly used in neuro-oncology. However, little is known about its application across European institutions and reasons for variable implementation.

Methods: Between June and August 2024, members of the European Organisation for Research and Treatment of Cancer - Brain Tumour Group (EORTC-BTG) completed a cross-sectional online survey on PET use in neuro-oncological practice.

Patritumab deruxtecan in leptomeningeal metastatic disease of solid tumors: the phase 2 TUXEDO-3 trial.

Leptomeningeal metastatic disease (LMD) is a severe complication of solid cancers with poor outcomes and limited treatment options. The antibody-drug conjugate patritumab deruxtecan (HER3-DXd) demonstrated efficacy in breast and lung cancers, and HER3 is involved in central nervous system metastases, particularly in parenchymal colonization. In this study, we investigated HER3-DXd efficacy and safety in patients with LMD in cohort 3 of the TUXEDO-3 phase 2 trial.

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.

RANO criteria for response assessment of brain metastases based on amino acid PET imaging.

Novel diagnostic and therapeutic opportunities are needed to improve medical care and outcome of patients with brain metastases, a frequent and severe complication of several cancer types. Currently, magnetic resonance imaging (MRI) is the primary method used for detection, treatment planning and disease monitoring in patients with brain metastases, but this method has limitations. These limitations mean that MRI can inform on lesion size but cannot directly measure the activity or viability of tumor tissue.

Effective targeting of PDGFRA-altered high-grade glioma with avapritinib.

PDGFRA is crucial to tumorigenesis and frequently genomically altered in high-grade glioma (HGG). In a comprehensive dataset of pediatric HGG (n = 261), we detect PDGFRA mutations and/or amplifications in 15% of cases, suggesting PDGFRA as a therapeutic target. We reveal that the PDGFRA/KIT inhibitor avapritinib shows (1) selectivity for PDGFRA inhibition, (2) distinct patterns of subcellular effects, (3) in vitro and in vivo activity in patient-derived HGG models, and (4) effective blood-brain barrier penetration in mice and humans.

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.

Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standard for PET imaging of brain metastases: version 1.0.

This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neuro-Oncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO). Brain metastases are the most common malignant central nervous system (CNS) tumors. PET imaging with radiolabeled amino acids and to lesser extent [F]FDG has gained considerable importance in the assessment of brain metastases, especially for the differential diagnosis between recurrent metastases and treatment-related changes which remains a limitation using conventional MRI.

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.

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.

Radiological assessment of Sella Turcica morphology correlates with skeletal classes in an Austrian population: an observational study.

Objectives: This study aimed to analyze variations in the sella turcica (ST) concerning its size, shape, and bridging, providing first reference values in Austrian individuals. Additionally, it assessed associations between these morphological and demographic parameters and their correlation with patients' skeletal class.

Methods: 208 lateral cephalometric radiographs (154 female, 54 male; age 8-58 years) from DPU Dental Clinic (Austria) were included.

Inequalities in access to neuro-oncology supportive care and rehabilitation: A survey of healthcare professionals' perspectives.

Background: Neuro-oncology patients and caregivers should have equitable access to rehabilitation, supportive-, and palliative care. To investigate existing issues and potential solutions, we surveyed neuro-oncology professionals to explore current barriers and facilitators to screening patients' needs and referral to services.

Methods: Members of the European Association of Neuro-Oncology and the European Organisation for Research and Treatment of Cancer Brain Tumor Group (EORTC-BTG) were invited to complete a 39-item online questionnaire covering the availability of services, screening, and referral practice.

Joint EANM/EANO/RANO/SNMMI practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor ligands: version 1.0.

Purpose: To provide practice guideline/procedure standards for diagnostics and therapy (theranostics) of meningiomas using radiolabeled somatostatin receptor (SSTR) ligands.

Methods: This joint practice guideline/procedure standard was collaboratively developed by the European Association of Nuclear Medicine (EANM), the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the European Association of Neurooncology (EANO), and the PET task force of the Response Assessment in Neurooncology Working Group (PET/RANO).

Results: Positron emission tomography (PET) using somatostatin receptor (SSTR) ligands can detect meningioma tissue with high sensitivity and specificity and may provide clinically relevant information beyond that obtained from structural magnetic resonance imaging (MRI) or computed tomography (CT) imaging alone.

7 Tesla magnetic resonance spectroscopic imaging predicting IDH status and glioma grading.

Introduction: With the application of high-resolution 3D 7 Tesla Magnetic Resonance Spectroscopy Imaging (MRSI) in high-grade gliomas, we previously identified intratumoral metabolic heterogeneities. In this study, we evaluated the potential of 3D 7 T-MRSI for the preoperative noninvasive classification of glioma grade and isocitrate dehydrogenase (IDH) status. We demonstrated that IDH mutation and glioma grade are detectable by ultra-high field (UHF) MRI.

Multi-Dynamic-Multi-Echo-based MRI for the Pre-Surgical Determination of Sellar Tumor Consistency: a Quantitative Approach for Predicting Lesion Resectability.

Purpose: Pre-surgical information about tumor consistency could facilitate neurosurgical planning. This study used multi-dynamic-multi-echo (MDME)-based relaxometry for the quantitative determination of pituitary tumor consistency, with the aim of predicting lesion resectability.

Methods: Seventy-two patients with suspected pituitary adenomas, who underwent preoperative 3 T MRI between January 2020 and January 2022, were included in this prospective study.