SPEAR: Spatial Epitranscriptomic Analysis by Mass Spectrometry Reveals Localized RNA Modification Remodeling During Glioma Progression

RNA modifications shape cell identity and disease, yet their spatial organization within tissues has remained largely inaccessible to existing technologies. NGS-based methods can map a limited number of individual modifications with spatial resolution, while liquid chromatography-tandem mass spectrometry (LC-MS/MS) provides comprehensive and quantitative coverage of the epitranscriptome from bulk, homogenized tissue. No current approach combines histological resolution, broad modification coverage, quantitative accuracy, and the sensitivity required for microscale clinical specimens. We present SPEAR (SPatial Epitranscriptomic Analysis by mass spectrometRy), a workflow coupling laser microdissection with a redesigned LC-MS/MS pipeline to enable quantitative epitranscriptomic profiling directly from formalin-fixed, paraffin-embedded (FFPE) tissue. This combination enables reproducible detection of dozens of RNA modifications from regions as small as 0.1 mm2, establishing a spatial scale previously inaccessible to mass spectrometry-based approaches. Applied to serial mouse brain sections, SPEAR resolved anatomically defined epitranscriptomic signatures across white and gray matter, establishing its spatial resolution and reproducibility in a controlled system. We then applied SPEAR to human diffuse gliomas containing, within individual specimens, both primary low-grade tumor regions and discrete foci undergoing transformation toward higher-grade malignancy. SPEAR resolved this transition directly, revealing a coordinated decrease in multiple methylated RNA modifications specifically within higher-grade regions, a spatially restricted signal that was masked by bulk analysis and reproducibly observed across patients despite underlying genetic heterogeneity. SPEAR establishes spatial epitranscriptomics as a tractable approach for molecular profiling of clinical tissue, providing a platform for biomarker discovery and molecular stratification based on the spatial organization of RNA modifications.