2021
DOI: 10.1093/noajnl/vdab149
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Intraoperative DNA methylation classification of brain tumors impacts neurosurgical strategy

Abstract: Background Brain 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 a… Show more

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Cited by 50 publications
(55 citation statements)
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“…In recent years, combined genome-wide DNA methylation and chromosomal copy number analysis by microarrays has gained considerable interest as a precise tool to classify benign and malignant tumors based on their individual, often lineage-reflecting methylation patterns [5][6][7][8]. Most prominently, the brain tumor methylation classifier has become a mainstay in neuropathological tumor diagnostics worldwide [5] and has already influenced several entity definitions in the 2016 WHO classification [9].…”
Section: Introductionmentioning
confidence: 99%
“…In recent years, combined genome-wide DNA methylation and chromosomal copy number analysis by microarrays has gained considerable interest as a precise tool to classify benign and malignant tumors based on their individual, often lineage-reflecting methylation patterns [5][6][7][8]. Most prominently, the brain tumor methylation classifier has become a mainstay in neuropathological tumor diagnostics worldwide [5] and has already influenced several entity definitions in the 2016 WHO classification [9].…”
Section: Introductionmentioning
confidence: 99%
“…Despite the limitations discussed above, the simplicity of native ONT sequencing and the number of features that can be extracted from a single run, combined with the low cost and portability of sequencer, make it an interesting proposition for clinical settings. Fast sample prep and sequencing times can allow a complete methylation analysis from sample preparation to computational classification in as little as 1-3 hours, enabling real-time medical applications in cancer (11,12). Because DNA methylation can differentiate non-cancer cell types as well, Nanopore liquid biopsy could be used to monitor collateral damage to adjacent tissue in cancer (23), or urgent conditions in other areas of medicine such as myocardial infarction, sepsis, and COVID-19 (4)(5)(6)41).…”
Section: Discussionmentioning
confidence: 99%
“…In regards to rapid data output, technology developed by Oxford Nanopore may speed up the diagnostic process. [89][90][91] Irrespective of the technical approach, a straightforward question addresses the potential for methylation-based classification of tumors from other origins. Would such approach be feasible for hematopoietic tumors?…”
Section: Outlook-what Is Nextmentioning
confidence: 99%
“…Chip‐based methylation analyses may be replaced by methylation sequencing if issues of reproducibility are solved. In regards to rapid data output, technology developed by Oxford Nanopore may speed up the diagnostic process 89–91 …”
Section: Outlook—what Is Nextmentioning
confidence: 99%