Pituitary stalk thickening: can a multiparametric MRI approach improve etiologic prediction?
Authors' conclusion
To our knowledge, this is the first study to propose MRI-based models using stalk morphology and signal features to predict PST etiology. These non-invasive models, developed without clinical input, demonstrate promising diagnostic accuracy and may aid in differential diagnosis. Further validation in larger cohorts is needed.
Study context
- Population
- Adult (51.2%) and pediatric (48.8%) patients with confirmed pituitary stalk thickening who underwent contrast-enhanced pituitary MRI, 2012–2021
- Participants
- 41 participants
- Comparison
- MRI morphological and signal features across pituitary stalk thickening (PST) etiologies
- Outcome
- Stalk thickness
Methodological detailsblinded consensus reading by two neuroradiologists
- Blinded consensus reading by two neuroradiologists
Performance
As reported in the abstract
P = 0.012
- Multivariable model (stalk thickness, non-T2 hypointensity, V-shaped enhancement) for neoplastic pathologies: AUC
- 0.848 (95% CI 0.713-0.982)
- Model (stalk thickness, T2 hypointensity) for inflammatory lesions: AUC
- 0.836 (95% CI 0.715-0.957)
Further findings
T2 signal intensity
- T2 hyperintensity in neoplastic lesions
- 70%
- T2 hypointensity more frequent in inflammatory/infectious lesions
- P = 0.017
Original publication
Pituitary stalk thickening: can a multiparametric MRI approach improve etiologic prediction? Pituitary. Published 12 January 2026. doi:10.
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