Modernizing Neuro-Oncology: The Impact of Imaging, Liquid Biopsies, and AI on Diagnosis and Treatment

International Journal of Molecular Sciences, Год журнала: 2025, Номер 26(3), С. 917 - 917

Опубликована: Янв. 22, 2025

Advances in neuro-oncology have transformed the diagnosis and management of brain tumors, which are among most challenging malignancies due to their high mortality rates complex neurological effects. Despite advancements surgery chemoradiotherapy, prognosis for glioblastoma multiforme (GBM) metastases remains poor, underscoring need innovative diagnostic strategies. This review highlights recent imaging techniques, liquid biopsies, artificial intelligence (AI) applications addressing current challenges. Advanced including diffusion tensor (DTI) magnetic resonance spectroscopy (MRS), improve differentiation tumor progression from treatment-related changes. Additionally, novel positron emission tomography (PET) radiotracers, such as 18F-fluoropivalate, 18F-fluoroethyltyrosine, 18F-fluluciclovine, facilitate metabolic profiling high-grade gliomas. Liquid biopsy, a minimally invasive technique, enables real-time monitoring biomarkers circulating DNA (ctDNA), extracellular vesicles (EVs), cells (CTCs), tumor-educated platelets (TEPs), enhancing precision. AI-driven algorithms, convolutional neural networks, integrate tools accuracy, reduce interobserver variability, accelerate clinical decision-making. These innovations advance personalized neuro-oncological care, offering new opportunities outcomes patients with central nervous system tumors. We advocate future research integrating these into workflows, accessibility challenges, standardizing methodologies ensure broad applicability neuro-oncology.

Язык: Английский

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Molecular Underpinnings of Brain Metastases

International Journal of Molecular Sciences, Год журнала: 2025, Номер 26(5), С. 2307 - 2307

Опубликована: Март 5, 2025

Brain metastases are the most commonly diagnosed type of central nervous system tumor, yet mechanisms their occurrence still widely unknown. Lung cancer, breast and melanoma common etiologies, but renal colorectal cancers have also been described as metastasizing to brain. Regardless origin, there for progression all types brain metastases, such creation a suitable tumor microenvironment in brain, priming cells, adaptations survive spreading lymphatic blood vessels, development penetrate blood-brain barrier. However, complex genetic molecular interactions that specific every primary making understanding metastatic tumors challenging field study. In this review, we aim summarize current knowledge on pathophysiology from characteristics cellular involved system. We briefly discuss challenges targeted therapies how is gap needs be overcome improve patient outcomes.

Язык: Английский

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A Practical, Short, [18F]F-DOPA PET/CT Acquisition Method for Distinguishing Recurrent Brain Metastases from Radionecrosis Following Radiotherapy

Journal of Clinical Medicine, Год журнала: 2025, Номер 14(7), С. 2168 - 2168

Опубликована: Март 22, 2025

Background/Objectives: Determining whether 3,4-dihydroxy-6-[18F]fluoro-L-phenylalanine positron emission tomography/computed tomography ([18F]F-DOPA PET/CT) data indicate brain metastasis progression (MP) or radionecrosis (RN) is challenging. The aim of this study was to present a method usable in the clinical setting without dedicated software that relies on less than five minutes SiPM PET/CT collected immediately after [18F]F-DOPA injection. Methods: We prospectively enrolled 15 patients with 19 lesions. Each acquisition conducted list mode (LM) for 25 min using four-ring system. reconstructed three volumes from LM file: duration 120 s (V120), 270 (V270), and 10 standard volume (Vclin). measured each lesion's maximum voxel activity (LSmax) corresponding mean its deviation (CLmean, CLsd). then calculated LSmax/CLmean ratio coefficient variation (COV), defined as 100 × (CLsd/CLmean). Results: Lesions were classified RN (n = 7) MP 12). For all volumes, differed significantly. COV parameter exhibited significant differences comparisons except V120 vs. V270. best diagnostic performances observed V270, an accuracy 94.7%. AUC values 97.6% both cases. Conclusions: A simple, static acquisition, starting 1.5 injection lasting minutes, permitted reaching excellent performance (100% sensitivity, 91.7% specificity, AUC) discriminating between MP.

Язык: Английский

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Plasma-First Testing in Advanced Lung Cancer: Evidence and Implications

Journal of Thoracic Oncology, Год журнала: 2025, Номер 20(4), С. 411 - 414

Опубликована: Апрель 1, 2025

Язык: Английский

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