Recent studies have provided significant insights into the molecular and genetic landscape of meningiomas, particularly focusing on the mutational profiles and their implications for tumor behavior. One study utilized single-cell DNA sequencing to elucidate the order of mutational acquisition in meningiomas with TRAF7/AKT1 and TRAF7/KLF4 mutations, revealing that mutations with higher variant allele frequencies (VAFs) are typically acquired earlier than those with lower VAFs (ref: Dogan doi.org/10.1007/s00401-022-02485-6/). Another investigation identified two predominant molecular subtypes of spinal meningiomas, highlighting a strong association between thoracic NF2-mutant tumors and female sex, while cervical AKT1-mutant tumors were found to originate ventral to the spinal cord (ref: Hua doi.org/10.1007/s00401-022-02474-9/). These findings underscore the importance of genetic profiling in understanding the clinical behavior of meningiomas and tailoring treatment strategies accordingly. Additionally, the role of epigenetic changes in meningioma progression has been explored, with one study employing methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) to investigate genomic and epigenomic instability in matched primary and recurrent meningiomas (ref: San-Miguel doi.org/10.3390/cancers14164008/). The study found that alterations in cell-death programs contribute significantly to tumor progression. Furthermore, transcriptomic analyses have identified dysregulated gene modules in grade 2 meningiomas, correlating with EZH2 expression and suggesting that these molecular signatures could serve as predictive markers for tumor behavior and patient outcomes (ref: Pereira doi.org/10.3171/2022.7.JNS22953/). Overall, these studies highlight the intricate genetic and molecular mechanisms underlying meningioma pathogenesis and their potential implications for clinical management.

Imaging techniques and biomarkers play a crucial role in the diagnosis and management of meningiomas, with recent studies focusing on advanced imaging modalities to improve diagnostic accuracy. One study demonstrated that histogram analysis of T1 mapping and apparent diffusion coefficient (ADC) values could serve as in vivo biomarkers for predicting the grade, subtype, and proliferative activity of meningiomas, achieving an area under the curve (AUC) of 0.864 when combining T1 C90 and ADC C10 parameters (ref: Cao doi.org/10.1007/s00330-022-09026-5/). This suggests that quantitative imaging metrics can enhance the preoperative assessment of meningiomas, potentially guiding treatment decisions. Moreover, the application of machine learning and radiomics in preoperative imaging has shown promise in predicting surgical outcomes. A study assessed the preoperative risk of achieving gross total resection (GTR) in skull meningiomas using radiomics derived from MR images, achieving high predictive accuracy for complete resections (ref: Musigmann doi.org/10.1038/s41598-022-18458-4/). Additionally, dynamic contrast-enhanced magnetic resonance perfusion imaging has been proposed as a potential predictor for grading meningiomas, with significant differences observed in the time to peak (Tmax) between low-grade and high-grade tumors (ref: Utomo doi.org/10.7150/ijms.75092/). These advancements in imaging and biomarker research are pivotal for improving diagnostic precision and tailoring therapeutic approaches in meningioma management.

The treatment landscape for meningiomas has evolved significantly, with various strategies being explored to optimize patient outcomes. Stereotactic radiosurgery (SRS) has emerged as a minimally invasive option for managing benign cavernous sinus meningiomas, demonstrating efficacy in controlling tumor growth and improving neurological function (ref: Santacroce doi.org/10.3390/cancers14164047/). A multicenter study highlighted the medium- to long-term outcomes of SRS, reinforcing its role as a viable alternative to traditional surgical approaches for small- to medium-sized tumors. In addition to SRS, the use of bevacizumab (BV) has been investigated in high-grade meningiomas, with a retrospective study revealing significant improvements in progression-free survival (PFS) and overall survival (OS) at 12 and 36 months post-surgery for patients receiving BV compared to those who did not (ref: Bai doi.org/10.2147/NDT.S368740/). Furthermore, somatostatin analogues have been evaluated for treatment-refractory meningiomas, with a systematic review indicating potential antitumor effects due to the high expression of somatostatin receptors in these tumors (ref: Jensen doi.org/10.1007/s10143-022-01849-6/). Collectively, these studies underscore the importance of personalized treatment strategies in managing meningiomas, particularly in cases of recurrence or treatment resistance.

Radiotherapy and radiosurgery are critical components in the management of meningiomas, particularly for cases that are not amenable to surgical resection. A systematic review comparing single-session versus multi-session stereotactic radiosurgery (SS-SRS vs. MS-SRS) found comparable tumor control rates at one and five years, suggesting that both approaches are effective for intracranial meningiomas (ref: Bin-Alamer doi.org/10.1007/s11060-022-04112-6/). This finding is significant as it provides flexibility in treatment planning based on patient-specific factors and tumor characteristics. Moreover, the phenomenon of pseudoprogression following Gamma Knife radiosurgery (GKRS) has been highlighted in recent studies, with findings indicating that intratumoral necrosis can lead to transient volume expansion, complicating the interpretation of post-treatment imaging (ref: Jung doi.org/10.1038/s41598-022-17813-9/). Understanding these dynamics is crucial for clinicians to differentiate between true progression and treatment-related changes. Additionally, the exploration of dose escalation strategies in high-risk grade 2 meningiomas has shown promise, with initial safety and efficacy analyses indicating that combining intensity-modulated radiotherapy with hypofractionated stereotactic radiotherapy may improve outcomes (ref: Pontoriero doi.org/10.1007/s11060-022-04107-3/). These advancements in radiotherapy techniques are essential for enhancing treatment efficacy and minimizing complications in meningioma management.

Clinical outcomes and prognostic factors in meningiomas are critical for guiding treatment decisions and predicting patient prognosis. Recent studies have focused on developing standardized imaging and reporting methods to enhance the accuracy of tumor characterization. One study introduced software solutions for automated tumor detection and standardized reporting, significantly reducing the time required for clinical report generation (ref: Bouget doi.org/10.3389/fneur.2022.932219/). This innovation aims to address the challenges posed by the variability in tumor characteristics and reporting practices. Additionally, the investigation of serum biomarkers such as IL-37 and IL-18 binding protein has revealed elevated levels in patients with both low-grade and high-grade brain tumors, suggesting their potential role in tumor characterization and monitoring (ref: Haghshenas doi.org/10.31557/APJCP.2022.23.8.2851/). Furthermore, a histopathological study classified meningioma capsules into distinct types based on tumor invasion, providing insights into the biological behavior of these tumors and their clinical implications (ref: Sugawara doi.org/10.2176/jns-nmc.2021-0402/). These findings emphasize the importance of integrating clinical, imaging, and molecular data to improve prognostic assessments and treatment strategies for meningioma patients.

Neurofibromatosis type 2 (NF2) is a genetic disorder characterized by the development of multiple tumors, including meningiomas and vestibular schwannomas. Recent research has highlighted the utility of advanced imaging techniques, such as 68 Ga-DOTATATE PET/CT, in identifying the tumor burden in NF2 patients, which often includes bilateral vestibular schwannomas and various nervous system tumors (ref: Filizoglu doi.org/10.1097/RLU.0000000000004355/). This imaging modality provides valuable insights into the extent of disease and aids in treatment planning. Moreover, the differentiation between spinal meningiomas and schwannomas has been enhanced through quantitative magnetic resonance imaging signal intensity analysis, allowing for more accurate preoperative diagnoses (ref: Hung doi.org/10.7150/ijms.73319/). The exploration of minimally invasive surgical techniques for resecting giant intracranial tumors has also gained attention, with studies demonstrating the feasibility of keyhole approaches in managing large tumors while minimizing morbidity (ref: Lan doi.org/10.1186/s41016-022-00289-x/). Collectively, these findings underscore the complexities associated with NF2 and its related tumors, highlighting the need for tailored diagnostic and therapeutic strategies.