{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:17:01Z","timestamp":1788308221719,"version":"build-2803163510"},"reference-count":22,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The methylation profile of meningiomas is a promising predictive tool that may improve risk stratification beyond WHO grading. This study aimed to evaluate the clinical relevance and real-world applicability of routine epigenetic testing in meningioma management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>The authors retrospectively analyzed patients who underwent meningioma resection between January 2021 and December 2023. Histopathological grading (WHO 2021) and methylation profiling (methylation class [MC]) with the MethylationEPIC v1.0 (850k) chip were performed by an independent neuropathologist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>A total of 106 patients were included; 81 tumors (76%) were classified as WHO grade 1, 20 (19%) as grade 2, and 5 (5%) as grade 3. Epigenetically, 55 tumors (52%) were classified as benign, 18 (17%) as intermediate, and 2 (2%) as malignant; 31 (29%) could not be classified. Discordances between WHO grading and methylation profiling were observed in 18 of 74 cases. Tumor board decisions were made after a median of 8 days postoperatively, guided by WHO grading; however, the epigenetic report was only available after a median of 23 days. During follow-up, 20 patients experienced tumor progression. Progression was significantly associated with the MC (r = \u22120.4, p &lt; 0.001) and tumor volume (r = 0.4, p = 0.0005), but not with WHO grading (r = 0.17, p = 0.084). However, the relatively high rate of unclassified tumors and delayed result availability limited the direct impact of MC profiling on immediate clinical decision-making. Interestingly, progression-free survival in MC-unclassified tumors mirrored that of the intermediate group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Methylation profiling demonstrates superior predictive accuracy for meningioma progression and complements WHO grading, especially in identifying malignant meningiomas. However, its current clinical utility is constrained by technical and logistical limitations. In real-world practice, epigenetic classification should therefore be considered a complementary tool rather than a replacement for established histopathological assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.6.focus26238","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:01:21Z","timestamp":1787702481000},"page":"E12","source":"Crossref","is-referenced-by-count":0,"title":["Meningioma methylation profiling as a complement to WHO grading: a single-center experience"],"prefix":"10.3171","volume":"61","author":[{"given":"Lydia","family":"Karamani","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University, Jena; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Paul Flechsig Institute of Neuropathology, Leipzig University Hospital, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Max","family":"Braune","sequence":"additional","affiliation":[{"name":"Paul Flechsig Institute of Neuropathology, Leipzig University Hospital, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Baumgarten","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University, Jena; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Senft","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jena University Hospital, Friedrich-Schiller-University, Jena; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"StatPearls","article-title":"Meningioma","author":"Alruwaili AA","year":"2024","unstructured":"Alruwaili AA, De Jesus O. Meningioma. In: StatPearls. StatPearls Publishing; 2024. Accessed July 15, 2026. https:\/\/pubmed.ncbi.nlm.nih.gov\/32809373\/"},{"issue":"9","key":"b2","series-title":"Acta Neurochir (Wien)","first-page":"2453","article-title":"The WHO 2021 Classification of Central Nervous System tumours: a practical update on what neurosurgeons need to know\u2014a minireview","volume":"164","author":"Torp SH","year":"2022","unstructured":"Torp SH, Solheim O, Skjulsvik AJ. The WHO 2021 Classification of Central Nervous System tumours: a practical update on what neurosurgeons need to know\u2014a minireview. 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Cancer. 2022;128(1):47\u201358. doi:10.1002\/cncr.33918"},{"issue":"2","key":"b5","series-title":"Neuro Oncol","first-page":"319","article-title":"cIMPACT-NOW Update 8: Clarifications on molecular risk parameters and recommendations for WHO grading of meningiomas","volume":"27","author":"Sahm F","year":"2025","unstructured":"Sahm F, Aldape KD, Brastianos PK,  cIMPACT-NOW Update 8: Clarifications on molecular risk parameters and recommendations for WHO grading of meningiomas. Neuro Oncol. 2025;27(2):319\u2013330. doi:10.1093\/neuonc\/noae170"},{"issue":"5","key":"b6","series-title":"Lancet Oncol","first-page":"682","article-title":"DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis","volume":"18","author":"Sahm F","year":"2017","unstructured":"Sahm F, Schrimpf D, Stichel D,  DNA methylation-based classification and grading system for meningioma: a multicentre, retrospective analysis. 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