Research into meningioma biology and genetics has revealed significant insights into the tumor's aggressiveness and recurrence patterns. A study utilizing single-cell RNA sequencing (scRNA-Seq) identified a unique initiating cell subpopulation (SULT1E1) that contributes to the malignancy of high-grade meningiomas, which often have poor outcomes despite surgical intervention (ref: Huang doi.org/10.1002/advs.202205525/). Another investigation focused on gene expression signatures across various meningioma subtypes, highlighting the need for improved understanding of the cellular processes and signaling pathways that drive tumor development (ref: Tsitsikov doi.org/10.3389/fonc.2023.1126550/). Additionally, the aberrant expression of Polycystin-2 (PC2) was linked to increased malignancy in meningiomas, with significant expression differences noted between tumor grades and normal brain tissue (ref: Assimakopoulou doi.org/10.1097/PAI.0000000000001113/). Furthermore, DNA methylation analysis has emerged as a valuable tool for predicting meningioma recurrence, providing a more nuanced classification of these tumors based on their methylation profiles (ref: Shen doi.org/10.1007/s00701-023-05550-5/). Lastly, preoperative MRI features have been shown to predict high-grade tumors, with specific characteristics such as necrosis and brain edema correlating with worse outcomes (ref: Radeesri doi.org/10.31557/APJCP.2023.24.3.819/).

Advancements in diagnostic imaging techniques have significantly improved the grading of meningiomas. A study comparing diffusion metrics, including diffusion kurtosis imaging (DKI) and neurite orientation dispersion and density imaging (NODDI), found promising correlations between these metrics and the Ki-67 index, suggesting their potential utility in tumor grading (ref: She doi.org/10.1007/s00330-023-09505-3/). Another investigation into the microstructure of meningiomas using diffusion MRI revealed that mean diffusivity (MD) and fractional anisotropy (FA) could provide insights into tumor cellularity, although the correlation with histological findings was not as strong as anticipated (ref: Brabec doi.org/10.1016/j.nicl.2023.103365/). The role of progestins in meningioma behavior was also examined, with findings indicating that discontinuation of progestin treatment could lead to changes in tumor characteristics (ref: Florea doi.org/10.3171/2022.12.JNS222006/). Moreover, a systematic review and meta-analysis evaluated the efficacy of radiotherapy and stereotactic radiosurgery in treating atypical and anaplastic meningiomas, revealing differences in recurrence rates based on treatment modality (ref: Gagliardi doi.org/10.1007/s10143-023-01969-7/).

Surgical techniques for meningioma resection have evolved, with new approaches being developed to enhance outcomes. A scoping review proposed a classification system for presigmoid approaches, emphasizing the need for standardized definitions to improve surgical perspectives in lateral skull base surgeries (ref: Hoz doi.org/10.3171/2023.2.JNS222227/). A retrospective study on postoperative Gamma Knife radiosurgery (GKRS) for WHO grade I meningiomas demonstrated a significant rate of radiological progression, highlighting the importance of long-term follow-up in surgical patients (ref: Yu doi.org/10.3389/fneur.2023.1094032/). The endoscopic transorbital approach (eTOA) has emerged as a promising technique for accessing complex skull base lesions, showing effective clinical utility in a series of cases (ref: Han doi.org/10.1007/s10143-023-01980-y/). Additionally, the endoscopic supraorbital eyebrow approach has been successfully applied for tuberculum sellae meningiomas, allowing for radical tumor removal with favorable surgical outcomes (ref: Sasaki doi.org/10.1016/j.wneu.2023.03.063/). Lastly, the upward bulging of the planum sphenoidale in anterior skull base meningiomas was classified, providing insights into surgical implications and potential challenges in tumor resection (ref: Cao doi.org/10.1097/SCS.0000000000008851/).

Treatment strategies for meningiomas have been diversified, focusing on improving patient outcomes through innovative approaches. Boron neutron capture therapy (BNCT) has been explored as a treatment option for recurrent meningiomas, particularly when surgical resection is not feasible (ref: Lan doi.org/10.3390/ijms24054978/). A systematic review and meta-analysis assessed the efficacy of radiotherapy versus stereotactic radiosurgery as adjuvant treatments for atypical and anaplastic meningiomas, revealing that stereotactic radiosurgery had a lower recurrence rate compared to radiotherapy (ref: Gagliardi doi.org/10.1007/s10143-023-01969-7/). Preoperative embolization has been shown to reduce surgical complications and improve clinical outcomes, although its utility remains debated (ref: Schartz doi.org/10.1007/s00062-023-01272-4/). Intraoperative ultrasound techniques have been refined to enhance the reliability of tumor resection in pediatric patients, indicating a shift towards more precise surgical interventions (ref: Frassanito doi.org/10.3390/diagnostics13050971/).

Understanding recurrence and prognostic factors in meningioma patients is crucial for improving management strategies. A retrospective study evaluated the risk of recurrence in patients with WHO grade I-III meningiomas, finding no significant increase in recurrence risk associated with brain invasion in grade I tumors (ref: Traylor doi.org/10.3171/2022.6.JNS221162/). Additionally, a multicenter study identified novel serum biomarkers for atypical meningiomas, linking tumor size and postoperative factors to recurrence rates (ref: Chang doi.org/10.1227/neu.0000000000002457/). The presence of preoperative seizures was found to be a significant predictor of early postoperative seizures, emphasizing the need for careful preoperative assessment (ref: McKevitt doi.org/10.1007/s00701-023-05571-0/). Furthermore, early-onset gliomas were associated with an increased risk of central nervous system tumors among relatives, suggesting a hereditary component to tumor development (ref: Alanen doi.org/10.1093/noajnl/).

Innovative therapies and the search for biomarkers in meningioma treatment are gaining traction. A systematic review on the use of somatostatin analogs in meningioma management highlighted the lack of approved drugs specifically targeting these tumors, underscoring the need for novel therapeutic options (ref: Tollefsen doi.org/10.3390/ijms24054793/). The identification of serum biomarkers for atypical meningiomas has shown promise in predicting prognosis, with specific postoperative factors correlating with recurrence rates (ref: Chang doi.org/10.1227/neu.0000000000002457/). DNA methylation analysis has emerged as a valuable diagnostic tool, aiding in the classification and recurrence prediction of meningiomas (ref: Shen doi.org/10.1007/s00701-023-05550-5/). Preoperative MRI features have also been linked to high-grade tumor predictions, further enhancing diagnostic capabilities (ref: Radeesri doi.org/10.31557/APJCP.2023.24.3.819/). Lastly, the development of optimal Gamma Knife treatment protocols is being explored to improve stereotactic radiosurgery outcomes for various brain lesions (ref: Tolakanahalli doi.org/10.1002/acm2.13936/).

Epidemiological studies have provided valuable insights into the incidence and survival rates of meningiomas. Data from the Brain Tumor Registry of Canada revealed trends in primary central nervous system tumors diagnosed between 2010 and 2015, emphasizing the importance of population-based data for understanding tumor behavior (ref: Walker doi.org/10.1093/nop/). Research into serum microRNAs as diagnostic biomarkers for gliomas demonstrated high accuracy in distinguishing glioma from non-cancer controls, indicating their potential utility in clinical practice (ref: Li doi.org/10.1186/s12864-023-09203-w/). A study on nonmalignant meningiomas identified heart disease and cerebrovascular disease as leading causes of death, highlighting the need for comprehensive patient management beyond tumor treatment (ref: Gawish doi.org/10.1016/j.wneu.2023.03.047/). Furthermore, a clinical diagnosis model for spinal meningiomas showed promising prognostic capabilities, aiding in risk stratification for patients (ref: Jiang doi.org/10.3389/fsurg.2023.1008605/).