Rapid DNA methylation-based classification of pediatric brain tumors from ultrasonic aspirate specimens

J Neurooncol. 2024 Aug;169(1):73-83. doi: 10.1007/s11060-024-04702-6. Epub 2024 May 21.

Abstract

Background: Although cavitating ultrasonic aspirators are commonly used in neurosurgical procedures, the suitability of ultrasonic aspirator-derived tumor material for diagnostic procedures is still controversial. Here, we explore the feasibility of using ultrasonic aspirator-resected tumor tissue to classify otherwise discarded sample material by fast DNA methylation-based analysis using low pass nanopore whole genome sequencing.

Methods: Ultrasonic aspirator-derived specimens from pediatric patients undergoing brain tumor resection were subjected to low-pass nanopore whole genome sequencing. DNA methylation-based classification using a neural network classifier and copy number variation analysis were performed. Tumor purity was estimated from copy number profiles. Results were compared to microarray (EPIC)-based routine neuropathological histomorphological and molecular evaluation.

Results: 19 samples with confirmed neuropathological diagnosis were evaluated. All samples were successfully sequenced and passed quality control for further analysis. DNA and sequencing characteristics from ultrasonic aspirator-derived specimens were comparable to routinely processed tumor tissue. Classification of both methods was concordant regarding methylation class in 17/19 (89%) cases. Application of a platform-specific threshold for nanopore-based classification ensured a specificity of 100%, whereas sensitivity was 79%. Copy number variation profiles were generated for all cases and matched EPIC results in 18/19 (95%) samples, even allowing the identification of diagnostically or therapeutically relevant genomic alterations.

Conclusion: Methylation-based classification of pediatric CNS tumors based on ultrasonic aspirator-reduced and otherwise discarded tissue is feasible using time- and cost-efficient nanopore sequencing.

Keywords: Nanopore sequencing; Pediatric brain cancer; Ultrasonic aspirator.

MeSH terms

  • Adolescent
  • Brain Neoplasms* / classification
  • Brain Neoplasms* / genetics
  • Brain Neoplasms* / pathology
  • Child
  • Child, Preschool
  • DNA Copy Number Variations
  • DNA Methylation*
  • Female
  • Humans
  • Infant
  • Male
  • Whole Genome Sequencing / methods