Pretreatment Diagnosis of Suprasellar Papillary Craniopharyngioma and Germ Cell Tumors of Adult Patients

Lee, H.-J.; Wu, Chao‐Hsiung; Wu, Hau Shin; Hung, Sheng-Che; Lirng, Jiing Feng; Luo, Chao-Bao; Chang, Feng Chi; Guo, Wan‐Yuo

doi:10.3174/ajnr.a4142

Cited by 18 publications

(7 citation statements)

References 24 publications

(26 reference statements)

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“…Correct diagnosis of the papillary type is essential for planning the therapeutic strategy, particularly to prevent tumor biopsy for histological confirmation when surgery is discarded as a primary treatment option. Nevertheless, there is inconsistent information regarding the radiological characteristics of PCPs, possibly related to the low resolution of the neuroradiological studies performed before the 1990s and the usual inaccurate definition of the MRI findings [11,17,19,[71][72][73][74][75]. The first comparative study of MRI features differentiating PCPs from ACPs, performed by Sartoretti-Schefer et al [72], identified the predominantly solid consistency and rounded shape as the two major morphological characteristics of the papillary type, in contrast to the usual mixed-solid consistency and lobulated morphology of the adamantinomatous one.…”

Section: Pcp Diagnosis: Specific Mri Characteristicsmentioning

confidence: 99%

Papillary Craniopharyngioma: A Type of Tumor Primarily Impairing the Hypothalamus – A Comprehensive Anatomo-Clinical Characterization of 350 Well-Described Cases

2021

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Objective: Papillary craniopharyngiomas (PCPs) represent a rare histological variant of craniopharyngiomas (CPs) usually involving the hypothalamus. This study systematically analyzes the clinical-anatomical correlation between tumor topography and symptoms related to hypothalamic dysfunction in the largest series of PCPs ever gathered. Methods: From 5,346 CP reports published from 1856 to 2021, we selected 350 well-described cases of the squamous-papillary type. Clinical presentation, tumor topography, severity of hypothalamic adhesion, patient outcome and tumor recurrence were thoroughly analyzed. Results: PCPs predominantly occur in adult (96.3%), male (61.7%) patients presenting with headache (63.4%), visual alterations (56.2%) and psychiatric disturbances (50.4%). Most PCPs are solid (50%), round (50%) lesions that occupy the third ventricle (3V, 94.8%) and show low-risk severity adhesions to the hypothalamus (66.8%). Two major topographical categories can be found: strictly 3V (57.5%), growing above an intact 3V floor (3VF) and not-strictly or infundibulo-tuberal (32.9%), expanding at the infundibulum and/or tuber cinereum. The hypothalamic syndrome predominated among strictly 3V PCPs (p<0.001). Psychiatric symptoms (p<0.001) and high-risk hypothalamic attachments (p=0.031) related to unfavorable postoperative outcomes among patients treated from 2006 onwards. The not-strictly 3V topography was identified as the major predictor of high-risk hypothalamic attachments (71.2% correctly predicted), which, along with incomplete tumor removal (p=0.018), underlies the higher tumor recurrence of this topography (p=0.001). Conclusions: This systematic review evidences that PCP topography is a major determinant of hypothalamic-related symptoms, type of hypothalamic attachments and tumor recurrence rate. Accurate preoperative definition of PCP-hypothalamus relationships is essential for the judicious, safe management of these complex lesions.

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Section: Pcp Diagnosis: Specific Mri Characteristicsmentioning

confidence: 99%

Papillary Craniopharyngioma: A Type of Tumor Primarily Impairing the Hypothalamus – A Comprehensive Anatomo-Clinical Characterization of 350 Well-Described Cases

2021

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“…e have read with great interest the original article by Lee et al, 1 "Pretreatment Diagnosis of Suprasellar Papillary Craniopharyngioma and Germ Cell Tumors of Adult Patients," recently published in the American Journal of Neuroradiology, which analyzes the MR imaging features of a series of 18 papillary craniopharyngiomas (PCPs), to achieve an accurate differential diagnosis between these lesions and the group of germ cell tumors involving the infundibulotuberal area. First and foremost, we would like to congratulate the authors for their thorough survey on such a challenging topographic variant of craniopharyngioma (CP), a topic rarely addressed in neuroradiologic research.…”

mentioning

confidence: 99%

Topographic Diagnosis of Papillary Craniopharyngiomas: The Need for an Accurate MRI-Surgical Correlation

Pascual¹,

Prieto²,

Castro-Dufourny³

et al. 2015

AJNR Am J Neuroradiol

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“…Researches on MRI, the most important examination for intracranial tumors, have shown that some imaging characteristics could be considered significant in the diagnosis. For example, the imaging characteristic of germinoma component is solid, which is predominant with the heterogeneous enhancement of the solid portion on the contrast-enhanced T1WI, while CP is cystic, which is predominant with a marginal enhancement of the multi-cystic lesion [24]. Meanwhile, the apparent diffusion coefficient (ADC) of CP is usually higher than germinoma on diffusion-weighted imaging (DWI) sequences [25].…”

Section: Discussionmentioning

confidence: 99%

Differentiation between Germinoma and Craniopharyngioma Using Radiomics-Based Machine Learning

Chen

Zhang

et al. 2022

JPM

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For the tumors located in the anterior skull base, germinoma and craniopharyngioma (CP) are unusual types with similar clinical manifestations and imaging features. The difference in treatment strategies and outcomes of patients highlights the importance of making an accurate preoperative diagnosis. This retrospective study enrolled 107 patients diagnosed with germinoma (n = 44) and CP (n = 63). The region of interest (ROI) was drawn independently by two researchers. Radiomic features were extracted from contrast-enhanced T1WI and T2WI sequences. Here, we established the diagnosis models with a combination of three selection methods, as well as three classifiers. After training the models, their performances were evaluated on the independent validation cohort and compared based on the index of the area under the receiver operating characteristic curve (AUC) in the validation cohort. Nine models were established and compared to find the optimal one defined with the highest AUC in the validation cohort. For the models applied in the contrast-enhanced T1WI images, RFS + RFC and LASSO + LDA were observed to be the optimal models with AUCs of 0.91. For the models applied in the T2WI images, DC + LDA and LASSO + LDA were observed to be the optimal models with AUCs of 0.88. The evidence of this study indicated that radiomics-based machine learning could be potentially considered as the radiological method in the presurgical differential diagnosis of germinoma and CP with a reliable diagnostic performance.

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Pretreatment Diagnosis of Suprasellar Papillary Craniopharyngioma and Germ Cell Tumors of Adult Patients

Cited by 18 publications

References 24 publications

Papillary Craniopharyngioma: A Type of Tumor Primarily Impairing the Hypothalamus – A Comprehensive Anatomo-Clinical Characterization of 350 Well-Described Cases

Papillary Craniopharyngioma: A Type of Tumor Primarily Impairing the Hypothalamus – A Comprehensive Anatomo-Clinical Characterization of 350 Well-Described Cases

Topographic Diagnosis of Papillary Craniopharyngiomas: The Need for an Accurate MRI-Surgical Correlation

Differentiation between Germinoma and Craniopharyngioma Using Radiomics-Based Machine Learning

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