Journal Article

DZNE-2026-00691

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Hetairos is a histology-based artificial intelligence model for predicting central nervous system tumor methylation subtypes

Jin, D. ; Shmatko, A. ; Patel, A. ; Rutz, S. ; Friedrich, L. ; Banan, R. ; Rahmanzade, R. ; Sievers, P. ; Hamelmann, S. ; Schrimpf, D. ; Göbel, K. ; Bogumil, H. ; Maas, S. L. N. ; Sill, M. ; Hinz, F. E. ; Suwala, A. K. ; Keller, F. ; Habel, A. ; Rukhovich, G. ; Zettl, F. ; Alhalabi, O. T. ; Ille, S. ; Sehring, J. ; Amsel, D. ; Wiestler, B. ; Piovesan Lago, P. ; Suchorska, B. ; Ahmad, O. ; Sturm, D. ; Reuss, D. ; Wesseling, P. ; Wöhrer, A. ; Heppner, F. L.DZNE* ; Blümcke, I. ; Delbridge, C. ; Jakobs, M. ; Herold-Mende, C. ; Krieg, S. M. ; Wick, W. ; Jones, D. T. W. ; Pfister, S. M. ; Al-Hussaini, M. ; Hou, Y. ; D’Almeida Costa, F. ; Schweizer, L. ; Bertero, L. ; Acker, T. ; Tauziede-Espariat, A. ; Varlet, P. ; Merkler, D. ; Egervari, K. ; Dohmen, H. ; Zoroquiain, P. ; Gejman, R. ; Brandner, S. ; Bai, X. ; von Deimling, A. ; Sahm, F. ; Gerstung, M.

2026
Nature Research London

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Please use a persistent id in citations: doi:10.1038/s43018-026-01186-3

Abstract: Molecular testing is essential for classifying central nervous system (CNS) tumors, with methylation profiling providing the highest diagnostic granularity. However, this requires more resources and time than conventional hematoxylin and eosin (H&E) histopathology, which is widely available globally. Here we propose Hetairos, an artificial intelligence algorithm that predicts 102 methylation-based CNS tumor subtypes from digital H&E slides. Built and validated on 9,606 patients and over 11,000 slides from 11 centers across four continents, Hetairos identified 50-70% of cases with high confidence, achieving an accuracy of 0.87 for its highest-rated predictions. Hetairos outperformed five board-certified neuropathologists in a direct histology-only comparison (0.68 versus 0.30). Prospective evaluation in routine diagnostics confirmed its performance, reducing turnaround time from 12 days (molecular testing) to 12 min. Hetairos supports diagnostic decision-making across the full spectrum of pediatric and adult CNS tumors by narrowing differential diagnoses and guiding efficient testing.

Keyword(s): Humans (MeSH) ; Central Nervous System Neoplasms: genetics (MeSH) ; Central Nervous System Neoplasms: pathology (MeSH) ; Central Nervous System Neoplasms: diagnosis (MeSH) ; Central Nervous System Neoplasms: classification (MeSH) ; Artificial Intelligence (MeSH) ; DNA Methylation (MeSH) ; Algorithms (MeSH)

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Contributing Institute(s):

1. Neuroimmunology (AG Heppner)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

Appears in the scientific report 2026

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Database coverage:
; ; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; DEAL Nature ; Essential Science Indicators ; IF >= 20 ; JCR ; National-Konsortium ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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