NICO Myriad Automated Preservation System improves meningioma sample quality for molecular pathology assays

Meningiomas are central nervous system tumors primarily treated by surgery and/or radiation with large variance in progression-free survival. Emerging molecular diagnostics such as circular RNA (circRNA) profiling show potential for enhancing diagnostic accuracy but are limited by the processing workflows associated with traditional fresh-frozen protocols that may lead to biomarker degradation. The NICO Automated Preservation System (APS) is a surgical tool that aspirates and resects intact tumor cores, quickly storing the removed tissue in a refrigerated environment of Ringer's Lactate fluid. To overcome the challenge of obtaining and preserving tissue for molecular diagnostics, we sought to test the extent to which the NICO APS enhances tissue preservation versus traditional protocols in 20 meningioma resections; we focused on circRNA profiles as potential clinical biomarkers. The NICO APS enhanced RNA integrity (P = .0023), yielding high-quality data (>Q30 median = 95%), which reduced the variation of circRNA detection. Weighted Gene Co-expression Network Analysis identified a total of 4 modules highlighting NICO and traditional protocols and meningioma grades. Modules belonging to WHO grade 2 meningiomas may be associated with cellular metabolism and epitranscriptomic regulation. Our results show that circRNA detection is highly improved using NICO APS.