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Topographical distribution and prevalence of basal duct–like recess sign in a cohort of Papillary Craniopharyngioma—novel findings and implications

  • Diagnostic Neuroradiology
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Abstract

Purpose

Basal duct-like recess (DR) sign serves as a specific marker of papillary craniopharyngiomas (PCPs) of the strictly third-ventricular (3 V) topography. Origins of this sign are poorly understood with limited validation in external cohorts.

Methods

In this retrospective study, MRIs of pathologically proven PCPs were reviewed and evaluated for tumor topography, DR sign prevalence, and morphological subtypes.

Results

Twenty-three cases with 24 MRIs satisfied our inclusion criteria. Median age was 44.5 years with a predominant male distribution (M/F ratio 4.7:1). Overall, strictly 3 V was the commonest tumor topography (8/24, 33.3%), and tumors were most commonly solid-cystic (10/24, 41.7%). The prevalence of DR sign was 21.7% (5/23 cases), all with strictly 3 V topography and with a predominantly solid consistency. The sensitivity, specificity and positive and negative predictive value of the DR sign for strict 3 V topography was 62.5%, 100%, 100% and 84.2% respectively. New pertinent findings associated with the DR sign were observed in our cohort. This included development of the cleft-like variant of DR sign after a 9-year follow-up initially absent at baseline imaging. Additionally, cystic dilatation of the basal tumor cleft at the pituitary stalk-tumor junction and presence of a vascular structure overlapping the DR sign were noted. Relevant mechanisms, hypotheses, and implications were explored.

Conclusion

We confirm the DR sign as a highly specific marker of the strictly 3 V topography in PCPs. While embryological and molecular factors remain pertinent in understanding origins of the DR sign, non-embryological mechanisms may play a role in development of the cleft-like variant.

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Data availability

The data that support the findings of this study are not openly available but are available from the corresponding author upon reasonable request.

Abbreviations

DR:

Duct-like recess

PCP:

Papillary craniopharyngioma

ACP:

Adamantinomatous craniopharyngioma

3V:

Third-ventricular

SPACE:

Sampling perfection with application optimized contrasts using different flip angle evolution

CISS:

Constructive interference in steady state

PEIR:

Persistent embryonic infundibular recess

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Authors and Affiliations

  1. Division of Neuroradiology, Department of Medical Imaging, St. Michael’s Hospital, University of Toronto, 30 Bond St, Toronto, ON, M5B 1W8, Canada

    Prateek Malik, Yingming Amy Chen, Aditya Bharatha & Shobhit Mathur

  2. Department of Pathology, St. Michael’s Hospital, University of Toronto, Toronto, Canada

    David G. Munoz

  3. Department of Radiodiagnosis, Christian Medical College, Vellore, Tamil Nadu, India

    Benjamin Barsouma Mathew, Bernice Thamarai Selvi, Harshad Arvind Vanjare, Anitha Jasper & Pavithra Mannam

Authors
  1. Prateek Malik
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Contributions

Conceptualization: PM; methodology: PM, SM; formal analysis and investigation: PM, BM; writing—original draft preparation: PM; writing—review and editing: PM, YAC, SM, AB, DGM, BTS, HV, AJ, PM; resources: DGM, SM, YAC, AB, PM, HV, BTS, AJ; supervision: SM, AB, PM.

Corresponding author

Correspondence to Shobhit Mathur.

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Ethical approval

This IRB approved research study was conducted retrospectively from data obtained for clinical purposes. All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed written consent was waived for this retrospective study after IRB review and submitted information is anonymized.

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Malik, P., Chen, Y.A., Mathew, B.B. et al. Topographical distribution and prevalence of basal duct–like recess sign in a cohort of Papillary Craniopharyngioma—novel findings and implications. Neuroradiology (2024). https://doi.org/10.1007/s00234-024-03355-6

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