Journal of Neuro-Oncology最新文献

{"title":"α-Synuclein suppresses glioma progression through the CDH13-JNK/c-Jun pathway.","authors":"Zhenwei Yu, Guoshi Huang, Gengxuan Yang, Qing Chang, Jing Zhang","doi":"10.1007/s11060-026-05775-1","DOIUrl":"10.1007/s11060-026-05775-1","url":null,"abstract":"<p><strong>Purpose: </strong>Gliomas are highly invasive primary brain tumors, and additional biomarkers are needed to improve prognostic stratification and clarify the mechanisms underlying tumor invasion. Although α-synuclein (α-syn), encoded by SNCA, is a central protein in neurodegenerative disease, its role in glioma remains poorly defined.</p><p><strong>Methods: </strong>SNCA/α-syn expression was evaluated in glioma specimens from Beijing Tiantan Hospital and in the Chinese Glioma Genome Atlas and The Cancer Genome Atlas cohorts. Associations with clinicopathological characteristics, molecular features, and overall survival were analyzed. Gain- and loss-of-function experiments were performed in U87 cells and patient-derived glioma stem-like cells (GSLCs), followed by proliferation, migration, invasion, and pathway-rescue assays. An orthotopic xenograft model was used to assess tumor growth and survival in vivo.</p><p><strong>Results: </strong>SNCA/α-syn expression was lower in high-grade gliomas and was associated with favorable molecular features and prolonged survival. α-Syn overexpression inhibited glioma cell proliferation, migration, and invasion, whereas α-syn knockdown promoted proliferation and invasion in GSLCs. Mechanistically, α-syn increased CDH13 expression, activated JNK/c-Jun signaling, and reduced MMP3 and MMP9 expression. CDH13 knockdown or JNK inhibition attenuated these effects and restored glioma cell migration and invasion. In vivo, α-syn overexpression suppressed orthotopic tumor growth and prolonged survival.</p><p><strong>Conclusion: </strong>High SNCA/α-syn expression is associated with favorable prognosis, whereas α-syn functions as a suppressor of glioma progression, at least partly through the CDH13-JNK/c-Jun axis.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes after a randomized phase II trial of nerve growth factor eye drops for optic pathway gliomas: four-year follow-up findings in children.","authors":"Antonio Ruggiero, Giorgio Attinà, Giorgio Placidi, Elena D'Agostino, Alessia Amato, Tommaso Verdolotti, Stefano Mastrangelo, Benedetto Falsini","doi":"10.1007/s11060-026-05777-z","DOIUrl":"10.1007/s11060-026-05777-z","url":null,"abstract":"<p><strong>Purpose: </strong>A previous double-blind, randomized, placebo-controlled, phase II clinical trial reported beneficial effects of a short-term treatment (10 days) with murine nerve growth factor (mNGF) eye drops on visual function in children with optic pathway gliomas (OPG). The present study aimed to evaluate long-term changes in clinical and neuroradiological parameters in the cohort of OPG patients who had previously participated in the phase II mNGF trial.</p><p><strong>Methods: </strong>Fifteen of the 18 patients originally enrolled in the phase II mNGF trial agreed to undergo clinical and neuroradiological monitoring over a 48-month follow-up period. Of these, 9 had originally been randomized to mNGF and 6 to placebo; no additional treatment (mNGF, chemotherapy, or radiotherapy) was administered during the extended follow-up. Every 6 months, patients underwent general clinical and neuro-ophthalmological examination, visual evoked potentials (VEP), and photopic negative response of the electroretinogram (PhNR). Brain MRI was performed every 12 months.</p><p><strong>Results: </strong>Comparison of initial and final follow-up median values revealed no statistically significant changes in visual acuity, VEP amplitude, PhNR amplitude, or visual field radius. No significant differences were observed in any parameter relative to baseline values of the mNGF trial. Brain MRI demonstrated stable disease in all patients throughout the observation period.</p><p><strong>Conclusion: </strong>These findings, obtained in an observational extension of the original randomized cohort, indicate favorable long-term safety and tolerability of a short-term course of topical mNGF in children with OPG, with sustained visual and neuroradiological stability over four years, rather than evidence of persistent treatment efficacy. Further prospective, adequately powered and randomized clinical studies are needed to confirm both the short- and long-term clinical efficacy of NGF treatment in preventing OPG-induced visual loss.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13534215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological response of primary central nervous system lymphoma after corticosteroid therapy and its predictive value on overall survival: a multicenter study.","authors":"Florian Scheichel, D Pinggera, T Rossmann, B Popadic, S Aspalter, V Schön, A Woehrer, M M Dorostkar, C Dorfer, C F Freyschlag, F Marhold","doi":"10.1007/s11060-026-05773-3","DOIUrl":"10.1007/s11060-026-05773-3","url":null,"abstract":"<p><strong>Background: </strong>Primary Large-B-Cell Lymphoma of the CNS (PCNS-LBCL) is a rare, aggressive tumor often sensitive to corticosteroid therapy (CST). This multicenter study investigated the spectrum of radiological responses to routine CST and evaluated its impact on patient prognosis.</p><p><strong>Methods: </strong>The researchers utilized a prospective cohort of 18 patients for volumetric MRI analysis and a combined prospective-retrospective cohort of 31 patients for 2D tumor analysis. Patients received CST post-biopsy, with follow-up MRIs performed on the seventh day (median) after surgery. The study correlated radiological responses with CST dosage, LDH levels, and overall survival (OS) using Kaplan-Meier and Firth-corrected Cox regression.</p><p><strong>Results: </strong>In the prospective cohort, 83.3% of tumors regressed with a median regression of 40%, while 16.7% progressed despite CST resulting in a median progression of 46%. These changes were not dose-dependent, but there were indications of a correlation with LDH levels. Patients showing regression had a median OS of 31.4 months, compared to 3.9 months for tumors progressing during CST (p = 0.015). Firth-corrected Cox regression showed, despite the small sample size, that radiological response (p = 0.02) could be a promising prognostic factor in a model including age, type of therapy and Karnofsky performance status.</p><p><strong>Conclusion: </strong>This study provides the first structured description of the range of radiological responses of PCNS-LBCL to CST. Furthermore, we found exploratory indications that radiological response to CST may predict outcome indicating shared sensitivity to other cytotoxic drugs. Further studies are necessary to fully understand diagnostic and prognostic implications of CST sensitivity in PCNS-LBCL and its underlying mechanisms.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525931/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extent of resection and craniopharyngioma recurrence: a volumetric analysis.","authors":"Sauradeep Sarkar, Sudharsan Vijayaraghavan, Sumit Thakar, Saritha Aryan","doi":"10.1007/s11060-026-05770-6","DOIUrl":"10.1007/s11060-026-05770-6","url":null,"abstract":"<p><strong>Purpose: </strong>The optimal extent of resection (EOR) required to minimize recurrence risk in craniopharyngioma remains unclear. The objective of this study was to quantitatively evaluate postoperative tumor volume and EOR as determinants of progression-free survival (PFS) in surgically treated adamantinomatous craniopharyngiomas.</p><p><strong>Methods: </strong>We retrospectively measured pre- and post-surgical tumor volumes in 60 patients using manual MRI-based segmentation. None received planned adjuvant radiotherapy. The median follow-up duration was 5 years. Clinical and volumetric variables were analyzed using Cox proportional hazards regression. Time-dependent receiver operating characteristic analysis at 3 years was also performed.</p><p><strong>Results: </strong>Tumor progression/recurrence occurred in 60% of patients. On univariable analysis, EOR was associated with improved PFS (HR 0.981 per 1% increase; 95% CI 0.966-0.997; p = 0.018), whereas increasing TV^solid (HR 1.178 per 1 cc increase; 95% CI 1.041-1.334; p = 0.010), residual cystic disease (HR 3.600; 95% CI 1.788-7.249; p < 0.001), and preoperative tumor volume (HR 1.006 per 1 cc increase; 95% CI 1.000-1.013; p = 0.044) were associated with increased progression risk. Given collinearity between EOR and TV^solid, separate multivariable models were constructed. EOR and TV^solid remained significantly associated with progression in their respective models, and residual cystic disease was associated with progression in both models. Optimism-corrected AUCs were 0.777 (95% CI, 0.649-0.927) for EOR and 0.813 (95% CI, 0.691-0.953) for TV^solid.</p><p><strong>Conclusions: </strong>EOR, TV^solid and the presence of residual cystic disease are independently associated with progression after craniopharyngioma resection. Risk stratification using tumor volumetry may help individualize postoperative decision-making in terms of surveillance versus adjuvant radiotherapy.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival and hematologic toxicity after whole-brain radiotherapy, photon craniospinal irradiation, and proton craniospinal irradiation for solid-tumor leptomeningeal disease: a systematic review.","authors":"Mishaal Munir, Kavita Sehrawat, Hanan Hassan, Matthew Hall, Minesh P Mehta, Jonathan T Yang, Rupesh Kotecha","doi":"10.1007/s11060-026-05776-0","DOIUrl":"10.1007/s11060-026-05776-0","url":null,"abstract":"<p><strong>Background: </strong>Leptomeningeal disease (LMD) from solid tumors carries poor prognosis and substantial neurologic morbidity. Radiotherapy is used for palliation and disease control, but outcomes across whole-brain radiotherapy (WBRT), photon craniospinal irradiation (CSI), and proton CSI remain incompletely defined.</p><p><strong>Methods: </strong>We conducted a PRISMA-based systematic review of PubMed-indexed studies reporting radiotherapy outcomes for adult solid-tumor LMD. Studies were categorized as photon WBRT/non-CSI, photon CSI, or proton CSI. Primary outcomes were median overall survival (OS) and progression-free survival (PFS), including CNS-PFS or intracranial PFS when reported. Grade ≥ 3 hematologic and non-hematologic toxicities were extracted when available.</p><p><strong>Results: </strong>Thirty-two unique studies/reports were included: 21 photon WBRT/non-CSI, 6 photon CSI, and 6 proton CSI studies. The median of reported median OS values were 4.5 months for photon WBRT/non-CSI, 4.1 months for photon CSI, and 10.7 months for proton CSI. Median PFS was 3.9 months for photon WBRT/non-CSI and 4.6 months for proton CSI; no extractable median PFS was available for photon CSI. Among studies with extractable denominators, crude pooled grade ≥ 3 hematologic toxicity was 2.8% for photon WBRT/non-CSI, 80.0% for photon CSI, and 59.4% for proton CSI; however, toxicity reporting was limited and heterogeneous.</p><p><strong>Conclusion: </strong>Proton CSI cohorts had numerically longer reported survival, but cross-study comparisons are limited by heterogeneity, treatment-era and selection differences, and systemic therapy exposure. These findings do not establish superiority over photon CSI and warrant prospective comparative evaluation.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in meningioma recurrence risk estimates across observational cohorts: the influence of calendar time, WHO classifications, geographical settings, and healthcare systems.","authors":"Christian Mirian, Lasse Rehné Jensen, Adam Gorm Hoffmann, Tareq A Juratli, Anders Broechner, Sverre H Torp, Helen A Shih, Ramin A Morshed, Jacob S Young, Stephen T Magill, Luca Bertero, Walter Stummer, Dorothee Cäcilia Spille, Benjamin Brokinkel, Soichi Oya, Satoru Miyawaki, Nobuhito Saito, Martin Proescholdt, Yasuhiro Kuroi, Konstantinos Gousias, Matthias Simon, Jennifer Moliterno, Ricardo Prat-Acin, Stéphane Goutagny, Vikram C Prabhu, John T Tsiang, Johannes Wach, Erdem Güresir, Junkoh Yamamoto, Young Zoon Kim, Joo Ho Lee, Daniel W Kim, Matthew Koshy, Karthikeyan Perumal, Mustafa K Baskaya, Donald M Cannon, Dennis C Shrieve, Chang-Ok Suh, Jong Hee Chang, Maria Kamenova, Sven Straumann, Jehuda Soleman, Ilker Y Eyüpoglu, Tony Catalan, Austin Lui, Philip V Theodosopoulos, Michael W McDermott, Fang Wang, Pedro Góes, Manoel Antonio de Paiva Neto, Ricardo Komotar, Michael E Ivan, Aria Jamshidi, Evan Luther, Luis Souhami, Marie-Christine Guiot, Tamás Csonka, Toshiki Endo, Olivia Claire Barrett, Randy Jensen, Tejpal Gupta, Akash J Patel, Tiemo J Klisch, Jun Won Kim, Francesco Maiuri, Valeria Barresi, María Dolores Tabernero, Simon Skyrman, Ian Law, Bjarne Winther Kristensen, Tina Nørgaard Munch, Torstein Meling, Kåre Fugleholm, Paul Blanche, Tiit Mathiesen, Andrea Daniela Maier","doi":"10.1007/s11060-026-05753-7","DOIUrl":"10.1007/s11060-026-05753-7","url":null,"abstract":"<p><strong>Purpose: </strong>Recurrence risk estimates underpin meningioma research, including molecular classification and clinical trial benchmarking, yet are often based on retrospective or historical data. The aim of this study was to assess the variation of recurrence risk estimates across calendar periods, WHO classification editions, geographical settings, and healthcare systems.thetermine METHODS: We analyzed 4,111 patients with primary WHO-1/-2 meningiomas from 31 centers in 15 countries (1990-2019). Recurrence was defined according to local radiological assessment. The 5- and 10-year recurrence risks were estimated using regression standardization with inverse probability of censoring weights, adjusting for key clinical, surgical, and histopathological variables.</p><p><strong>Results: </strong>Recurrence risk estimates varied across all domains examined. More recent calendar periods were associated with higher predicted recurrence risk, particularly for WHO-2 at 5 years (e.g., ≥ 2013 vs. ≤ 2007: RR 1.60, 95% CI 1.19-2.01). Differences were also observed across healthcare systems and geographical settings despite adjustment. In contrast, recurrence risk estimates were broadly comparable between WHO classification editions (2007 vs. 2016). Cohort-level visualization revealed substantial heterogeneity in follow-up duration, inclusion patterns, and recurrence detection.</p><p><strong>Conclusions: </strong>Recurrence risk estimates are not stable across time or settings and are influenced by several patterns, particularly data accrual patterns. Recurrence events are inherently \"locked\" to the historical context in which they were detected, which may have important implications for developing molecular classifiers using retrospective specimens and clinical trials relying on benchmark established in historical settings. We propose transparent visualization of observational cohort composition and individual-level event timing to improve interpretability and comparability.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal laser interstitial thermal therapy for treatment of chordoma: single-center experience and literature review.","authors":"Sumeeth V Jonathan, Jeffrey W Chen, Kevin Wu, Alex R Flores, Amol J Ghia, Gil Kimchi, Robert Y North, Christopher A Alvarez-Breckenridge, Laurence D Rhines, Claudio E Tatsui","doi":"10.1007/s11060-026-05764-4","DOIUrl":"10.1007/s11060-026-05764-4","url":null,"abstract":"<p><strong>Purpose: </strong>Chordomas are rare, locally aggressive tumors for which effective salvage options are limited once maximal surgical and radiation therapy have been exhausted. Laser interstitial thermal therapy (LITT) is a minimally invasive, MRI-guided ablative technique established for spinal metastases, but published experience with LITT for chordoma remains limited to isolated case reports. We report the largest clinical experience with spinal LITT (sLITT) for chordoma and review the existing literature.</p><p><strong>Methods: </strong>We performed a retrospective, IRB-approved single-institution case series of patients with histologically confirmed chordoma treated with sLITT. Clinical, operative, and radiographic data were abstracted, including tumor volumes, ablation parameters, and functional and oncologic outcomes. A systematic PubMed search was performed to identify all prior published reports of LITT for chordoma.</p><p><strong>Results: </strong>Four patients underwent sLITT across five procedures, treating metastatic foci from primary sacral, clival, and cervical chordomas, as well as one primary thoracic lesion. sLITT was used as salvage treatment in four procedures and as primary treatment in one patient to avoid the morbidity of open surgery. Median time from diagnosis to LITT was 19.1 months (range 2.5-168.3), and pre-operative KPS was 90-100 in all patients. A median of four laser fibers and 16 ablations were used per procedure (12-15 W). Median case duration was 352.5 min and length of stay was two days. Postoperative SRS was administered in all but one procedure. All patients experienced volumetric tumor reduction on the earliest post-operative MRI (median 4.2 months, range 2.8-8.8), with a mean reduction of 25.7% ± 12.7%. Median radiographic follow-up was 16.8 months (range 3.5-48.1). No procedure required additional intervention at the LITT-treated site, and no progression at the treated site was identified on available follow-up imaging. Median overall survival from LITT was 23.0 months. One procedure was complicated by transient radiculopathy that resolved with steroids. Literature review identified four previously published case reports of LITT for chordoma, three of which described complete thermal ablation with radiographic response; our series represents the largest reported clinical experience to date.</p><p><strong>Conclusion: </strong>This series represents the largest reported clinical experience with LITT for chordoma and provides proof-of-concept supporting prospective evaluation of this technique. sLITT was technically feasible and well tolerated in this small chordoma cohort, applied both as salvage therapy and, in one patient, as primary local treatment. Because SRS followed all but one procedure, the independent contribution of sLITT to the radiographic responses observed cannot be determined from these data.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAR-T cell therapy: potential for paediatric brain tumours-an update.","authors":"Alexandra Zehner, Benjamin Draper, Darren Hargrave, Laura K Donovan, John Anderson","doi":"10.1007/s11060-026-05604-5","DOIUrl":"10.1007/s11060-026-05604-5","url":null,"abstract":"<p><p>Central nervous system (CNS) tumours are the deadliest cancer for children and currently present limited treatment options. Chimeric antigen receptor (CAR)-T cell therapies have emerged as an innovative approach supported by encouraging clinical results. Current clinical trials using CAR-T cells in the treatment of paediatric CNS cancers differ in a number of variables, including the CAR-T cell route of delivery, presence of lymphodepletion, identified target antigen, and CAR engineering features. Considering early learnings across these areas is an essential step to developing more effective treatment options, especially given the challenges of immunosuppressive tumour microenvironments, various toxicities, CAR-T cell exhaustion, and tumour antigen heterogeneity. In sum, while there is a need for continued innovation, CAR-T cells represent a promising treatment approach for this devastating category of diseases.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology-validated structural and physiologic habitat imaging for differentiating radiation necrosis from tumor recurrence in brain metastases.","authors":"Ji Eun Park, Guowen Shao, Shivani Baisiwala, Nakyoung Kim, Amelia Tan, Francesco Sanvito, Andrea Liang, Zexi Wang, Gianluca Nocera, Catalina Raymond, Viên Lam Le, Ho Sung Kim, Noriko Salamon, Whitney B Pope, Won Kim, Benjamin M Ellingson, Jingwen Yao","doi":"10.1007/s11060-026-05761-7","DOIUrl":"10.1007/s11060-026-05761-7","url":null,"abstract":"<p><strong>Purpose: </strong>Differentiating tumor recurrence from radiation necrosis (RN) after stereotactic radiosurgery (SRS) remains a major diagnostic challenge in brain metastasis. We aimed to validate established MRI-based tumor habitat analysis for distinguishing tumor from RN in an independent cohort with histopathological ground truth.</p><p><strong>Materials and methods: </strong>This retrospective study included 104 patients (104 lesions) with pathologically confirmed recurrent metastatic tumors (n = 68) or RN (n = 36) who underwent structural and physiologic MRI. Tumor habitats were generated using an established unsupervised clustering model applied to normalized T1-weighted enhanced, T2-weighted, apparent diffusion coefficient, and cerebral blood volume maps. Structural habitats (enhancing tissue, solid low-enhancing, nonviable) and physiologic habitats (hypervascular, hypovascular cellular, nonviable) were quantified as absolute volumes and volume fractions. Logistic regression and receiver operating characteristics analysis evaluated the ability to differentiate tumor and RN. Composite habitat scores integrating structural and physiologic habitats were also developed.</p><p><strong>Results: </strong>Recurrent metastatic tumors showed higher contrast-enhancing volume (P = .006), higher solid low-enhancing habitat volume (P = .029) and fraction (P = .04), higher hypervascular habitat volume (P = .02) and fraction (P = .03), and lower nonviable tissue habitat fractions on structural (P = .003) and physiologic MRI (P = .015), compared with RN. The combined structural and physiologic MRI habitat score showed the highest diagnostic performance (AUC, 0.80; 95% CI: 0.71-0.87; sensitivity, 89.7%; specificity, 58.3%).</p><p><strong>Conclusion: </strong>MRI-based tumor habitat analysis provides a pathology-validated approach to distinguish tumor recurrence from radiation necrosis in patients with prior radiation therapy.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pregnancy and neonatal outcomes in patients treated for glioma before or during pregnancy: a single-institution retrospective series.","authors":"Allison R Valerius, Annabella Strathman, Andrew E Rodriguez, Ugur Sener, Joon Uhm, Daniel Lachance, Bryan J Neth, Jian Campian, Terry C Burns, Ian F Parney, Fredric B Meyer, Nadia Laack, Paul Decker, Michael W Ruff","doi":"10.1007/s11060-026-05765-3","DOIUrl":"10.1007/s11060-026-05765-3","url":null,"abstract":"<p><strong>Background: </strong>Glioma diagnosed during pregnancy and pregnancy following glioma treatment present complex management challenges. Safety of glioma treatment during pregnancy is not well established. The ability to counsel patients on timing of conception after treatment remains limited. The aim of this study was to describe our institution's experience with pregnancy during and/or after treatment for glioma.</p><p><strong>Methods: </strong>In this single-institution study, we retrospectively identified patients diagnosed with glioma during or prior to pregnancy and described treatment courses and maternal and neonatal outcomes.</p><p><strong>Results: </strong>Twenty-one female patients were included. Glioma diagnoses included 12 high-grade tumors and 9 low-grade tumors. Cohort A consisted of 8 patients who presented with glioma during pregnancy, of which, 7 underwent glioma treatment during pregnancy. All pregnancies in cohort A were without significant maternal complications and resulted in delivery of a healthy neonate. Cohort B consisted of 13 patients who experienced pregnancy after a prior diagnosis of glioma, totaling 18 pregnancies that resulted in delivery of a neonate. Antepartum course was complicated by seizure in 3/18 pregnancies. Functionally inconsequential anatomic abnormalities in childhood offspring of cohort B occurred in 5/18 pregnancies. Anatomic abnormalities occurred in 4/13 (31%) of temozolomide exposed offspring and 1/5 (20%) of temozolomide unexposed offspring.</p><p><strong>Conclusions: </strong>In this retrospective series, diagnosis of glioma before or during pregnancy was associated with generally favorable maternal, fetal and childhood outcomes. We observed higher-than-expected rate of anatomic abnormalities in the post-diagnosis cohort, though none carried meaningful functional consequences. These findings add to the limited literature exploring pregnancy outcomes in patients with glioma.</p>","PeriodicalId":16425,"journal":{"name":"Journal of Neuro-Oncology","volume":"179 2","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}