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Using blood, urine, and cerebrospinal fluid, cfDNA/ctDNA, RNA, extracellular vesicles, and tumor-associated proteins can support molecular diagnosis and treatment-response assessment. This mini review synthesizes recent seminal studies and outlines detection approaches across different biofluids, targets, and tumor types.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/liquid-biopsy-in-pediatric-brain-tumors-mini-review/385459/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/liquid-biopsy-in-pediatric-brain-tumors-mini-review/385459.png","ImageObject",300,407,{"name":92,"@type":93},"RuangKosong","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-01","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",12,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"Why are standard diagnosis and monitoring methods difficult for pediatric brain tumors?","Question",{"text":113,"@type":114},"Diagnosis based on clinical evaluation and MRI can be uncertain, and current monitoring during and after treatment is limited by poor sensitivity and specificity for true tumor growth. This creates a need for safer, non-invasive alternatives.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What materials can be analyzed in liquid biopsy for pediatric brain tumors?",{"text":118,"@type":114},"Liquid biopsy can use blood, urine, and cerebrospinal fluid to sample cfDNA, ctDNA, RNA, extracellular vesicles, and tumor-associated proteins.",{"name":120,"@type":111,"acceptedAnswer":121},"How does liquid biopsy help distinguish progression from pseudoprogression?",{"text":122,"@type":114},"A reliable, non-invasive method could differentiate progression from pseudoprogression, reducing the need for repeat biopsy and enabling earlier, more appropriate treatment decisions.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},385459,1790619244,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},962090883219,"https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c","TYPE Mini Review  \nPUBLISHED 06 January 2023  \nDOI 10.3389/fgene.2022.1114762  \nOPEN ACCESS  \nEDITED BY  \nXinzhong Li,  \nTeesside University, United Kingdom  \nREVIEWED BY  \nDavid Meredith,  \nBrigham and Women’s Hospital and Harvard Medical School, United States  \n*CORRESPONDENCE  \nCarl Koschmann,  \n [ckoschma@med.umich.edu](ckoschma@med.umich.edu)  \n†These authors have contributed equally to this work  \nSPECIALTY SECTION  \nThis article was submitted to Neurogenomics, a section of the journal Frontiers in Genetics  \nRECEIVED 02 December 2022  \nACCEPTED 23 December 2022  \nPUBLISHED 06 January 2023  \nCITATION  \nTripathy A, John V, Wadden J, Kong S, Sharba S and Koschmann C (2023), Liquid biopsy in pediatric brain tumors.  \nFront. Genet. 13:1114762 .  \ndoi: 10.3389/fgene.2022.1114762  \nCOPYRIGHT  \n© 2023 Tripathy, John, Wadden, Kong, Sharba and Koschmann. This is an openaccess article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.  \nLiquid biopsy in pediatric brain tumors  \nArushi Tripathy 1†, Vishal John 2†, Jack Wadden 2, Seongbae Kong 2, Sana Sharba 2 and Carl Koschmann 2*  \n1 Department of Neurosurgery, Michigan Medicine, Ann Arbor, MI, United States, 2Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, United States  \nMalignant primary brain tumors are the most common cancer in children aged 0–14 years, and are the most common cause of death among pediatric cancer patients. Compared to other cancers, pediatric brain tumors have been difficult to diagnose and study given the high risk of intracranial biopsy penetrating through vital midline structures, where the majority of pediatric brain tumors originate (Ostrom et al., 2015) . Furthermore, the vast majority of these tumors recur. With limitations in the ability to monitor using clinical and radiographic methods alone, minimally invasive methods such as liquid biopsy will be crucial to our understanding and treatment. Liquid biopsy of blood, urine, and cerebrospinal fluid (CSF) can be used to sample cfDNA, ctDNA, RNA, extracellular vesicles, and tumor-associated proteins. In the past year, four seminal papers have made significant advances in the use of liquid biopsy in pediatric brain tumor patients (Liu et al., 2021; Cantor et al., 2022; Miller et al., 2022; Pagès et al., 2022) . In this review, we integrate the results of these studies and others to discuss how the newest technologies in liquid biopsy are being developed for molecular diagnosis and treatment response in pediatric brain tumors.  \nKEYWORDS  \nliquid biopsy, pediatric, brain tumor, cell-free tumor DNA (cf-tDNA), cerebrospinal fluid (CSF), plasma, targeted treatment  \nIntroduction  \nThe most common cause of death among pediatric cancer patients aged 0–14 years are malignant primary brain tumors (Ostrom et al., 2020) . Unfortunately, diagnosis via clinical evaluation and MRI imaging is uncertain, with a differential diagnosis including abscesses and tumor variants requiring discordant treatments. Therefore, current clinical decision-making requires surgical biopsy or resection for histopathologic diagnosis. Even the most minimally invasive option–stereotactic needle biopsy–puts the patient at risk of side effects of general anesthesia, intracranial hemorrhage, neurologic deficit, and death (Nishihara et al., 2011; Hamisch et al., 2017; He et al., 2021). Furthermore, tissue biopsy samples a single point, failing to capture intratumoral heterogeneity for accurate diagnosis (Ng and Lim, 2008) . It has previously been shown that neuropathologic diagnosis via stereotactic biopsy specimen versus tumor resection specimen of the same lesion differed i","cbCaifax7en2DBe8","https://ap.wps.com/l/cbCaifax7en2DBe8","pdf",874787,"English","# Introduction\n## Clinical challenges in pediatric brain tumor diagnosis\n## Limits of imaging-based monitoring and pseudoprogression\n# Liquid biopsy approaches\n## Biofluids and molecular targets\n## Summary of detection methods (Table 1)","[{\"question\":\"Why are standard diagnosis and monitoring methods difficult for pediatric brain tumors?\",\"answer\":\"Diagnosis based on clinical evaluation and MRI can be uncertain, and current monitoring during and after treatment is limited by poor sensitivity and specificity for true tumor growth. This creates a need for safer, non-invasive alternatives.\"},{\"question\":\"What materials can be analyzed in liquid biopsy for pediatric brain tumors?\",\"answer\":\"Liquid biopsy can use blood, urine, and cerebrospinal fluid to sample cfDNA, ctDNA, RNA, extracellular vesicles, and tumor-associated proteins.\"},{\"question\":\"How does liquid biopsy help distinguish progression from pseudoprogression?\",\"answer\":\"A reliable, non-invasive method could differentiate progression from pseudoprogression, reducing the need for repeat biopsy and enabling earlier, more appropriate treatment decisions.\"}]","Liquid biopsy in pediatric brain tumors - Mini Review | PDF",1790269366,18]