Diagnostic advances and challenges in meningioma

Abstract

Introduction: The rising incidence of meningiomas, coupled with the aggressive behavior observed in a subset of these tumors, presents significant clinical challenges. Accurate diagnosis and risk stratification are essential for effective patient management.

Areas covered: This review offers a comprehensive overview of the evolving diagnostic landscape for meningiomas. It examines the roles of MRI, CT, and PET imaging - particularly somatostatin receptor type 2 (SSTR2) PET - in tumor detection and differentiation. In addition, it discusses the integration of molecular markers into the 2021 WHO classification and highlights the potential of multiomics analyses to enhance tumor classification and prognostication. It also addresses challenges related to standardization, clinical implementation, and accessibility of these advanced diagnostic tools. A literature search was conducted using PubMed and clinicaltrials.gov to identify clinical trials exploring the use of SSTR2 PET and treatments informed by molecular diagnostic findings.

Expert opinion: The integration of molecular data with advanced imaging techniques offers significant promise for the development of an integrated diagnostic framework for meningiomas. This approach has the potential to improve risk stratification and support the implementation of personalized treatment strategies. However, achieving this will require extensive correlative research and the establishment of large, high-quality datasets that combine imaging, molecular, and clinical information.

Keywords: DOTATATE PET; Meningioma; SSTR2; antimicrobial stewardship; methylation profiling; multiomics; neurosurgery; olecular profiling; prognostication; targeted therapy; theranostics.