{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:59:39Z","timestamp":1791197979216,"version":"4.1.0"},"reference-count":71,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Gliomas have undergone a profound redefinition over the past decade, transitioning from morphology\u2010based entities to biologically coherent diseases defined by molecular alterations. The 2021 WHO Classification of Tumors of the Central Nervous System and its 2022 update formalize this shift, establishing integrated diagnosis as the global standard and identifying essential biomarkers\u2014including\n                    <jats:italic>IDH<\/jats:italic>\n                    mutations, 1p\/19q codeletion,\n                    <jats:italic>ATRX<\/jats:italic>\n                    loss,\n                    <jats:italic>TP53<\/jats:italic>\n                    mutation,\n                    <jats:italic>TERT<\/jats:italic>\n                    promoter mutation,\n                    <jats:italic>EGFR<\/jats:italic>\n                    amplification, and +7\/\u221210 cytogenetics\u2014that shape prognosis, therapeutic decision\u2010making, and clinical trial eligibility. In this review, we synthesize the current molecular taxonomy of gliomas and compare recommendations from major international guidelines (WHO, NCCN, EANO) and the Italian Association of Neuro\u2010Oncology (AINO). Recognizing that contemporary practice employs a complementary, purpose\u2010driven array of diagnostic modalities\u2014from immunohistochemistry and PCR\u2010based methods to next\u2010generation sequencing and DNA methylation profiling\u2014we critically examine the profound global disparities that hinder implementation, focusing on economic constraints, infrastructural limitations, regulatory barriers, and workforce shortages. By integrating health\u2010economic evidence, we demonstrate that the societal and financial burden of non\u2010implementation far exceeds the investment required for molecular testing. We propose a tiered implementation framework in which clinically actionable information is obtainable for most glioma patients through accessible, cost\u2010effective technologies, with more resource\u2010intensive modalities reserved for specific clinical scenarios. Ensuring equitable access to integrated diagnostics, defined as the right test for the right clinical question, is essential not only for precision neuro\u2010oncology but also for global healthcare justice and scientific progress.\n                  <\/jats:p>","DOI":"10.1002\/acn3.70503","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T07:16:36Z","timestamp":1785222996000},"page":"1968-1977","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Price of Precision: A Critical Review of Molecular Diagnostics in Glioma, From Guidelines to Global Disparities"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3745-9953","authenticated-orcid":false,"given":"Maria","family":"Guarnaccia","sequence":"first","affiliation":[{"name":"Institute for Biomedical Research and Innovation (IRIB) National Research Council (CNR)  Catania Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7590-1792","authenticated-orcid":false,"given":"Sebastiano","family":"Cavallaro","sequence":"additional","affiliation":[{"name":"Institute for Biomedical Research and Innovation (IRIB) National Research Council (CNR)  Catania 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