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A
B
Figure 1. A: Schematic of diffusion of tumor nucleic acids, proteins, metabolites, and microvesicles into various extracellular
compartments; B: Representative MRi images of an intraventricular (left) and mainly parenchymal (right) tumor with cerebrospinal fluid
(CSF) contact points denoted in red and parenchymal contact points denoted in green
sensitivities and specificities of 100% in a series of 112 patients with gliomas, non-small cell lung cancer,
[74]
and controls . Numerous studies examining serum miRNA signatures in gastric cancer, hepatocellular
carcinoma, lung cancer, and breast cancer have also demonstrated the potentially powerful predictive value
of serum miRNA in screening, risk-stratifying, and tracking cancer patients [75-79] .
In the realm of pediatric neuro-oncology, however, serum miRNA have only begun to be leveraged for
tumor detection and screening. The first study to examine the potential utility of serum miRNA in detecting
[41]
and screening pediatric brain tumors was done by this author and their colleagues (Bookland et al. ) in
a small cohort of pediatric juvenile pilocytic astrocytoma, ependymoma, and control patients. The authors
identified four miRNA (miR-21, miR-15b, miR-23a, and miR-146b) that accurately predicted the presence,
tumor nodule size, and response to therapy of juvenile pilocytic astrocytoma patients with a sensitivity of
