Predicting isocitrate dehydrogenase (IDH) mutations in gliomas using magnetic resonance imaging (MRI) is clinically important for treatment planning. This study compared two artificial intelligence (AI) models, GliomaDepth-IDH (ResNet34-based) and GliomaVista-IDH (Vision Transformer-based), with 18 physicians (eight neuroradiologists, five neurosurgeons, and five neurosurgery residents) in predicting IDH mutation status. On the Brain Tumor Segmentation Challenge dataset, the GliomaVista-IDH AI model achieved an area under the curve (AUC) value of 0.97, significantly outperforming all physician groups. However, external validation on a Japanese cohort revealed performance degradation: GliomaDepth-IDH declined to an AUC of 0.75 and GliomaVista-IDH to 0.82, with GliomaVista-IDH showing significant calibration issues (Brier score = 0.32). High-performing physicians achieved comparable results (AUC = 0.88) with superior calibration (Brier score = 0.19). Inter-rater reliability analysis revealed substantial variability across physician groups. These findings suggest that AI models can assist many physicians, while experienced practitioners remain competitive with better-calibrated predictions in challenging domains.

TFH cells in intracranial TILs from CD4-cre/Bcl6fl/fl mice

Additional TIL data related to myeloid-B-TFH cell axis

Gating strategy for myeloid cells in flow cytometry analysis

TLS in brain metastases of patients with NSCLC, and B and plasma cell cluster in the murine intracranial TME

The progression of isocitrate dehydrogenase-mutant glioma (IDH-G) from slow-growing tumor to fatal disease is associated with transcriptional and DNA methylation changes that remain poorly understood. Here, we profiled a longitudinal cohort of 36 IDH-G samples from 19 patients by joint-capture multi-omic single-nucleus DNA methylation, single-nucleus RNA sequencing and bulk exome sequencing. We show that IDH-G progression is associated with an increase in malignant stem-like states, decreased differentiation and methylation loss, which marks tumors with worse clinical outcome. Methylation loss was uniformly observed across malignant cells within individual tumors, suggesting that it may underlie rather than result from the increase in stem-like states. Analysis of cell-state heritability and plasticity using high-resolution phylogenetic trees links DNA methylation loss to alterations in glioma cell-state encoding and heritability. Our study offers insights into how DNA methylation loss reshapes cellular transitions and how it may mark clinically more aggressive tumors across IDH-G subsets.

Recent advances in molecular profiling have revealed that ependymomas are biologically distinct entities with unique molecular alterations and clinical behaviors. These findings have been incorporated into the 2021 WHO Classification of Tumors of the Central Nervous System, integrating anatomical location and molecular features into the diagnostic framework. This review summarizes the current molecular classification of ependymomas, role of DNA methylation profiling in diagnosis, and biological and clinical characteristics of the major molecular subgroups. Additionally, we discuss current treatment strategies, molecular risk stratification, and future directions in the management of ependymomas.

Additional data related the effects of anti-PD-1 and anti-CTLA-4 mAbs on TILs

Glioblastoma (GBM) is the most aggressive primary brain tumor, with a poor prognosis despite advances in multimodal treatment. Current standard of care includes maximal safe resection and radiotherapy with concomitant and adjuvant temozolomide, which is called the Stupp regimen. Tumor-treating fields are incorporated into standard therapies and have demonstrated survival benefits in newly diagnosed GBM. Bevacizumab improves progression-free survival; however, its effect on overall survival remains limited. Recent advances in comprehensive molecular analyses have accelerated the development of novel therapies for GBM. Oncolytic virotherapy has emerged as a promising strategy for inducing direct tumor lysis and antitumor immunity. Immune checkpoint inhibitors, dendritic cell vaccines, CAR-T cell therapy, and gene therapy have been actively investigated. Precision oncology approaches based on genomic profiling, including basket and umbrella trials, are expanding the therapeutic possibilities for selected patients with actionable alterations.

Gender equity, work-life balance, and career development have become important concerns in the medical profession. However, empirical evidence on how neuro-oncology professionals experience working conditions, career barriers, and perceived inequity remains limited. We conducted a nationwide, cross-sectional, anonymous online survey of members of the Japan Society for Neuro-Oncology (JSNO) to evaluate working conditions, career-related concerns, job satisfaction, perceived workplace discrimination, and organizational challenges. Among 292 respondents (response rate, 35.9

Neuroendoscopic surgery, which allows tumor removal through a narrow surgical corridor, has been increasingly applied to intraventricular tumors. Although this approach is often regarded as minimally invasive, the restricted operative field and proximity to critical deep brain structures necessitate precise surgical manipulation. Periventricular vein injury can result in serious postoperative neurological deficits, underscoring the importance of meticulous dissection and hemostasis. During tumor removal, preservation of venous drainage should be prioritized. Aggressive resection should be avoided when strong adhesion to the veins is encountered. Gentle counterpressure using small cotton patties, combined with irrigation and suction, facilitated safe dissection and effective venous bleeding control. Hemostasis in neuroendoscopic surgery demands patience. The accurate identification of bleeding points is key. Blind coagulation in a blood-filled field should be avoided. Temporary packing with cotton patties can be effective without interrupting surgical workflow. The appropriate use of angled endoscopes and flexible transitions between the dry and wet fields is important for the reliable assessment of residual tumors and hemostasis. Furthermore, careful consideration of surgical instruments and timely conversion to microscopic surgery, when necessary, are critical for minimizing complications. Mastery of these principles can facilitate a safer neuroendoscopic management of intraventricular tumors.

Characteristics of patients with non-small-cell lung cancer brain metastases

Gating strategy for T cells in flow cytometry analysis