Abstract Background: Decoding the origins of cell-free DNA (cfDNA) released from dying cells in a liquid biopsy sample offers the potential to provide insight into the dynamic, organism-wide changes reflective of health and disease, making cfDNA an ideal target for serial, minimally invasive monitoring of disease-related changes. To this end, cell-type specific DNA methylation patterns offer a promising target to facilitate tissue of origin analysis, yet limited methods exist to identify differentially methylated regions that distinguish cell-types. Methods: We develop a robust differentially methylated marker region identification pipeline, DiMMER, that leverages cfDNA fragment level information of neighboring, co-regulated CpG sites on methylome-wide sequencing reads. Compared to prior methods that utilize simple heuristics in one-vs-all average methylation rate comparisons, we implement an individual pairwise statistical test procedure across all cell-types or groups under consideration. We assess the cell-specific nature of identified differentially methylated marker regions by generating in-silico mixtures from known cell-type of origin at each region, and calculating the area under the receiver operating characteristic curve (AUROC). We utilize our differentially methylated marker finding pipeline to identify melanocyte specific methylation marker regions and assess their functional role through annotations. We show these cell-specific regions are conserved in melanoma cell-lines and are distinct from the aberrant changes in a cancer context. Results: We identified the most cell-type specific differentially methylated marker regions across 24 distinct cell-type groups using our pipeline. Compared to a simpler one-vs-all heuristic, we demonstrate improved cell-type specificity evidenced by a higher AUROC on average. Using our pipeline we identified melanocyte-specific marker regions, which were commonly found in intronic and promoter regions of genes related to melanocyte development and differentiation. When comparing methylation patterns between melanocytes and melanoma cell-lines, we demonstrate melanocyte specific methylation marks are conserved through the transformation to malignant melanoma. Conclusion: As methylome-wide sequencing methods continue to rapidly develop and more cell-specific methylation data is generated, there is unmet need for more statistically robust differentially methylated marker finding tools. Here we present one such tool, DiMMER, and demonstrate the potential utility of identifying such regions to be used to assess organ-specific load as a measure of residual disease, as opposed to traditional circulating tumor DNA quanitification. Citation Format: Arthur P McDeed, Sidharth S Jain, Megan E McNamara, Amber Alley, Anton Wellstein, Jaeil Ahn. DiMMER: A robust computational pipeline for differential methylation marker evaluation in R of cell-free DNA fragments [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr B063.
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