ArticleNeuro-oncology advances
Intraoperative DNA methylation classification of brain tumors impacts neurosurgical strategy.
Article in Neuro-oncology advances. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 66 papers, 1 of them a synthesis that pooled it.
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Who cites it
66 citing papers in PubMed, 1 synthesis or guideline pooled it, 83 citations in OpenAlex.
- DNA Methylation-Based Classification for Central Nervous System Tumours: A Health Technology Assessment.Ontario health technology assessment series · 2025Pooled it
- A multi-analyte blood test for acute spinal cord injury.The Journal of clinical investigation · 2025Trial
- A theoretical and experimental framework enables low-coverage sequencing for accurate quantification of genome-wide cytosine modification levels.NAR genomics and bioinformatics · 2026Article
- Methylation profiling and alternative classification approaches in a glioma-enriched FFPE stereotaxic biopsy cohort.Acta neuropathologica communications · 2026Article
- Association of recurrence patterns and outcome with HR and HER2 status in patients with resected brain metastases from breast cancer.International journal of cancer · 2026Article
- The emerging role of intraoperative nanopore sequencing on the neurosurgical strategy in paediatric embryonal brain tumours.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026Review
- Long-read sequencing technologies and bioinformatics: a new perspective for decoding DNA methylation modifications.Journal of translational medicine · 2026Review
- Clinical utility of sarcoma methylation classifiers in soft tissue sarcoma diagnosis.Journal of cancer research and clinical oncology · 2026Article
- Neurosurgical Application of Artificial Intelligence in Pediatric Neuro-Oncology.Journal of Korean Neurosurgical Society · 2026Article
- MGMT promoter methylation modulates the effect of residual tumor on survival after re-resection of recurrent glioblastoma.Acta neuropathologica communications · 2026Article
- The utility of intraoperative magnetic resonance imaging in recurrent glioblastoma surgery: A volumetric analysis.Brain & spine · 2026Article
- Brain tumor classification from FFPE samples using nanopore methylation sequencing.NAR cancer · 2025Article
- Rapid intraoperative genetic analysis of adult-type diffuse gliomas using a microfluidic real-time polymerase chain reaction device.Neuro-oncology · 2025Article
- Strategies for the Molecular Classification of Medulloblastoma.Biomedicines · 2025Review
- GLIMMER: an interim subgroup analysis from an ongoing prospective study evaluating hyperspectral imaging for MGMT promoter methylation in gliomas.Journal of neuro-oncology · 2025Observational
- Introduction of whole genome sequencing as NHS standard of care for glioma patients in two neurosurgical oncology centres: West Midlands.BJC reports · 2025Article
- Employing nanopore sequencing on FFPE-derived DNA for CNS tumor diagnostics.Acta neuropathologica communications · 2025Article
- Tracing the evolution of sequencing into the era of genomic medicine.Nature reviews. Genetics · 2025Review
- Rapid epigenomic classification of acute leukemia.Nature genetics · 2025Article
- ROBIN: A unified nanopore-based assay integrating intraoperative methylome classification and next-day comprehensive profiling for ultra-rapid tumor diagnosis.Neuro-oncology · 2025Article
6 more citing papers are in PubMed but not listed here.
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Authors and funding
12 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBrain tumor surgery must balance the benefit of maximal resection against the risk of inflicting severe damage. The impact of increased resection is diagnosis-specific. However, the precise diagnosis is typically uncertain at surgery due to limitations of imaging and intraoperative histomorphological methods. Novel and accurate strategies for brain tumor classification are necessary to support personalized intraoperative neurosurgical treatment decisions. Here, we describe a fast and cost-efficient workflow for intraoperative classification of brain tumors based on DNA methylation profiles generated by low coverage nanopore sequencing and machine learning algorithms.
methodsWe evaluated 6 independent cohorts containing 105 patients, including 50 pediatric and 55 adult patients. Ultra-low coverage whole-genome sequencing was performed on nanopore flow cells. Data were analyzed using copy number variation and ad hoc random forest classifier for the genome-wide methylation-based classification of the tumor.
resultsConcordant classification was obtained between nanopore DNA methylation analysis and a full neuropathological evaluation in 93 of 105 (89%) cases. The analysis demonstrated correct diagnosis in 6/6 cases where frozen section evaluation was inconclusive. Results could be returned to the operating room at a median of 97 min (range 91-161 min). Precise classification of the tumor entity and subtype would have supported modification of the surgical strategy in 12 out of 20 patients evaluated intraoperatively.
conclusionIntraoperative nanopore sequencing combined with machine learning diagnostics was robust, sensitive, and rapid. This strategy allowed DNA methylation-based classification of the tumor to be returned to the surgeon within a timeframe that supports intraoperative decision making.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.