The diagnosis and classification of meningiomas have evolved significantly with the introduction of new criteria and methodologies. A pivotal study by Rebchuk examined the impact of brain invasion criteria on the incidence and distribution of WHO grade 1, 2, and 3 meningiomas, revealing that the 2016 WHO criteria led to a notable shift in the classification of these tumors, particularly in the incidence of grade 2 meningiomas (ref: Rebchuk doi.org/10.1093/neuonc/). Meanwhile, Bayley’s research highlighted the limitations of traditional histopathological grading, demonstrating that DNA methylation and RNA-sequencing approaches provided a more accurate classification of aggressive tumors, suggesting the existence of three biological subtypes of meningiomas (ref: Bayley doi.org/10.1126/sciadv.abm6247/). Additionally, the study by Arsene explored the viral oncogenesis in CNS tumors, finding a significant association between HPV presence and meningiomas, which raises questions about the etiology of these tumors (ref: Arsene doi.org/10.1111/jcmm.17064/). The integration of machine learning techniques for the segmentation of HE-stained pathological images, as demonstrated by Wu, indicates a shift towards more automated and precise diagnostic methods, although challenges remain in fully automating this process (ref: Wu doi.org/10.1371/journal.pone.0263006/). Zhang's work on a radiomic model for differentiating transitional from atypical meningiomas further emphasizes the importance of imaging in preoperative assessments, revealing significant differences in radiomic features that could guide surgical decisions (ref: Zhang doi.org/10.3389/fonc.2022.811767/).

The treatment of meningiomas, particularly through surgical interventions, has been the focus of numerous studies aimed at improving patient outcomes. Castle-Kirszbaum's investigation into endoscopic endonasal surgery for anterior skull base meningiomas found that larger tumors and visual failure at presentation correlated with worse quality of life (QOL), while visual improvements post-surgery were predictive of enhanced QOL (ref: Castle-Kirszbaum doi.org/10.3171/2021.11.JNS212090/). In a broader analysis of CNS tumors, Moore identified that young adult males exhibited worse survival rates compared to females, independent of treatment types, indicating a need for tailored approaches in this demographic (ref: Moore doi.org/10.1002/cncr.34120/). Ding's study on combined microscopic and endoscopic surgery for pineal region meningiomas demonstrated that this approach effectively addresses the limitations of traditional methods, enhancing surgical outcomes (ref: Ding doi.org/10.3389/fonc.2022.828361/). Furthermore, Sun's deep learning radiomics model for identifying sinus invasion preoperatively showed promise in guiding surgical strategies, potentially leading to better surgical planning and outcomes (ref: Sun doi.org/10.1016/j.ejrad.2022.110187/). Samanci's report on Gamma Knife radiosurgery for tuberculum sellae meningiomas provided valuable insights into the effectiveness of this treatment modality, marking it as a significant option for managing these tumors (ref: Samanci doi.org/10.1007/s10143-022-01753-z/).

Research into the risk factors associated with meningiomas has revealed intriguing associations and potential causal links. Schlehofer's study within the INTERPHONE project found that while allergic diseases showed a reduced odds ratio for glioma, they did not exhibit the same protective effect for meningiomas, indicating distinct etiological pathways (ref: Schlehofer doi.org/10.1007/s10654-022-00843-y/). In contrast, a systematic review by Lee highlighted a significant association between high doses of cyproterone acetate and increased risk of meningioma, suggesting that hormonal factors may play a role in tumor development (ref: Lee doi.org/10.1038/s41598-022-05773-z/). Roytman's investigation into somatostatin receptor expression and tumor vascularity in meningiomas indicated that these biological markers could have implications for prognosis and treatment strategies (ref: Roytman doi.org/10.3389/fonc.2021.820287/). Fatima's work on hearing outcomes following surgery for cerebellopontine angle meningiomas emphasized the importance of timely intervention to preserve auditory function, further underscoring the multifaceted nature of meningioma management (ref: Fatima doi.org/10.1007/s11060-022-03958-0/).

Advancements in imaging techniques and radiomics have significantly enhanced the diagnostic and prognostic capabilities for meningiomas. Zhang's study on a radiomic model for differentiating transitional from atypical meningiomas demonstrated that specific radiomic features could effectively aid in preoperative decision-making, improving surgical outcomes (ref: Zhang doi.org/10.3389/fonc.2022.811767/). Lingl's research on amide proton transfer-weighted (APTw) CEST MRI showcased its potential in differentiating intracranial tumors, suggesting that this technique could become a valuable tool in routine clinical assessments (ref: Lingl doi.org/10.3390/diagnostics12020490/). Wach's investigation into the correlation between tumor location, proliferative potential, and neurological function emphasized the importance of anatomical considerations in meningioma prognosis, revealing that location significantly impacts patient outcomes (ref: Wach doi.org/10.3390/cancers14041033/). Bhattacharjee's work on AI techniques for analyzing MRI scans further illustrates the growing role of artificial intelligence in enhancing diagnostic accuracy and efficiency in meningioma evaluations (ref: Bhattacharjee doi.org/10.4258/hir.2022.28.1.46/). Sun's deep learning model for identifying sinus invasion preoperatively also contributes to the evolving landscape of radiomics, highlighting its potential to inform surgical strategies (ref: Sun doi.org/10.1016/j.ejrad.2022.110187/).

The exploration of genetic factors and biomarkers in meningiomas has unveiled critical insights into tumor behavior and patient outcomes. Rutland's study identified a significant association between mutations in the DNA polymerase epsilon gene and increased CD8+ cell infiltration, suggesting that these genetic alterations may influence immune response and tumor progression (ref: Rutland doi.org/10.3171/2021.11.FOCUS21592/). Marletta's research on the expression of CD13 as a diagnostic marker for meningiomas demonstrated its utility in differentiating meningiomas from mimicking tumors, achieving high sensitivity and specificity (ref: Marletta doi.org/10.1007/s00428-022-03304-9/). Lee's systematic review on cyproterone acetate further elucidated the hormonal influences on meningioma risk, indicating that high doses are associated with increased tumor incidence, which may have implications for clinical management (ref: Lee doi.org/10.1038/s41598-022-05773-z/). Wu's work on the segmentation of HE-stained pathological images using machine learning highlights the potential for automated diagnostic tools in identifying meningioma characteristics, although challenges remain in achieving full automation (ref: Wu doi.org/10.1371/journal.pone.0263006/).

Epidemiological studies on meningiomas have revealed significant demographic trends and survival disparities. Moore's analysis of the National Cancer Database highlighted that young adult males diagnosed with CNS tumors, including meningiomas, have worse survival outcomes compared to females, suggesting a need for gender-specific treatment approaches (ref: Moore doi.org/10.1002/cncr.34120/). Liang's retrospective analysis of atypical meningiomas provided insights into clinical characteristics and treatment outcomes, emphasizing the importance of thorough follow-up in this patient population (ref: Liang doi.org/10.21037/tcr-21-375/). Cole's nationwide analysis of frailty status in patients undergoing meningioma surgery indicated that frailty is a more significant predictor of postoperative outcomes than age, underscoring the need for comprehensive preoperative assessments (ref: Cole doi.org/10.1016/j.ejso.2022.02.015/). Wu's work on HE-stained image segmentation also contributes to understanding the histopathological features of meningiomas, which can aid in epidemiological studies (ref: Wu doi.org/10.1371/journal.pone.0263006/).

Innovative surgical techniques are transforming the management of meningiomas, enhancing safety and efficacy. Li's protocol for a randomized trial on the use of tranexamic acid in meningioma surgery aims to assess its safety and efficacy in reducing blood loss, addressing concerns about postoperative seizures associated with its use (ref: Li doi.org/10.1136/bmjopen-2021-052095/). Liu's study on spinal epidural angiolipomas misdiagnosed as meningiomas underscores the importance of accurate imaging to differentiate between these entities, which can significantly impact surgical planning (ref: Liu doi.org/10.1007/s13760-022-01881-9/). Yang's investigation into the supraorbital keyhole approach for anterior skull base tumors demonstrated its feasibility and flexibility, providing a less invasive option for tumor resection (ref: Yang doi.org/10.1097/SCS.0000000000008497/). Patel's bibliometric analysis of stereotactic radiosurgery highlights its growing role in meningioma management, emphasizing the need for ongoing research to optimize treatment strategies (ref: Patel doi.org/10.1080/02688697.2022.2034745/).

The relationship between meningiomas and neurological function is a critical area of research, with implications for treatment and patient quality of life. Wach's study on the correlation between tumor location, proliferative potential, and neurological function emphasized that meningiomas located at the skull base may present unique challenges and outcomes compared to those in other locations (ref: Wach doi.org/10.3390/cancers14041033/). Castle-Kirszbaum's research on endoscopic endonasal surgery for anterior skull base meningiomas found that visual function is closely tied to quality of life, with improvements in vision post-surgery significantly enhancing patient well-being (ref: Castle-Kirszbaum doi.org/10.3171/2021.11.JNS212090/). Moore's analysis of survival disparities among young adults with CNS tumors, including meningiomas, highlights the need for tailored approaches to improve outcomes in this demographic (ref: Moore doi.org/10.1002/cncr.34120/). Wu's work on HE-stained image segmentation also contributes to understanding the histopathological features that may correlate with neurological outcomes (ref: Wu doi.org/10.1371/journal.pone.0263006/).