{
  "abstract": "Background: Accurate histopathological diagnosis is essential for the management of patients undergoing surgery for suspected high-grade glioma (HGG). We evaluated the diagnostic accuracy of pathological assessment performed in a general pathology department and a specialist neuropathology department, using EPIC-based DNA methylation classification as the operational reference standard.\n\nMethods: This retrospective diagnostic accuracy study included 130 patients with complete results from three diagnostic assessments (selected from 173 screened records) with intracranial space-occupying lesions who underwent surgical biopsy or resection between May 2019 and February 2025. Tissue specimens were assessed in a general pathology department and subsequently evaluated independently in a specialist neuropathology department, followed by DNA methylation profiling using the Illumina Infinium MethylationEPIC BeadChip. HGGs (CNS WHO grades 3–4) were classified as positive and all other lesions as negative.\n\nResults: Assessment in the general pathology department yielded 20 HGG classifications discordant with the EPIC reference (false negatives), including 13 tumors initially classified as low-grade gliomas, two as other intracranial lesions, and five as non-neoplastic brain tissue. Sensitivity was 79%, specificity 100%, positive predictive value 100%, negative predictive value 62%, and overall accuracy 84%. Specialist neuropathological assessment achieved a sensitivity of 100%, specificity of 97%, positive predictive value of 99%, negative predictive value of 100%, and overall accuracy of 99%. Three cases differed in specific classification or binary status: two HGG diagnoses were further refined as glioblastoma, IDH-wildtype, CNS WHO grade 4, while one specimen interpreted histopathologically as showing proliferative and mitotic activity was classified as tumor-free brain tissue by DNA methylation profiling.\n\nConclusions: Specialist neuropathological assessment showed high agreement with the EPIC-based reference classification for HGGs, whereas assessment outside a specialized neuropathology setting showed lower sensitivity for HGG identification in this selected cohort. DNA methylation profiling provides complementary diagnostic value by refining tumour classification.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Neurosurgery, Vivantes Klinikum Im Friedrichshain, Berlin, Germany",
    "Department of Neurosurgery, Helios Klinikum Erfurt, Erfurt, Germany",
    "Department of Neuropathology, Charité – Universitätsmedizin Berlin, Berlin, Germany",
    "Department for Continuing Education, University of Oxford, Oxford, UK"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Timotheos Christoforou"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Umida Elmuradova"
    },
    {
      "affs": [
        0
      ],
      "name": "Stefanie Hammersen"
    },
    {
      "affs": [
        2
      ],
      "name": "Arend Koch"
    },
    {
      "affs": [
        0
      ],
      "name": "Sven Kantelhardt"
    },
    {
      "affs": [
        0,
        3
      ],
      "name": "Ali Mulhem",
      "orcid": "0000-0002-2614-610X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/8rcw0qa3z88f1.bib",
  "cited_by": 0,
  "doi": "10.1007/s00701-026-07078-w",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13710634/",
  "id": "8rcw0qa3z88f1",
  "issns": [
    "0001-6268",
    "0942-0940"
  ],
  "landing_url": "https://doi.org/10.1007/s00701-026-07078-w",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2716|Glioma Diagnosis and Treatment"
    ]
  ],
  "openalex": "W7223476435",
  "pdf_url": null,
  "pmcid": "PMC13710634",
  "pmid": "42931851",
  "published": "2026-10-24",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/8rcw0qa3z88f1.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:21:33Z",
      "native_id": "PMC13710634",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00701-026-07078-w"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2716|Glioma Diagnosis and Treatment",
      "subfield": "human-genetics"
    }
  ],
  "title": "Diagnostic accuracy of neuropathological assessment across different diagnostic settings for high-grade gliomas: the added value of DNA methylation profiling",
  "title_text": "Diagnostic accuracy of neuropathological assessment across different diagnostic settings for high-grade gliomas: the added value of DNA methylation profiling",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:21:33Z",
  "url": "https://research.draconitic.com/paper/8rcw0qa3z88f1",
  "venue": "Acta Neurochirurgica",
  "versions": []
}