The polystyrene beads sign: a simple MRI marker for the preoperative diagnosis of papillary hypothalamic craniopharyngiomas
Authors' conclusion
The polystyrene beads sign is a simple and reproducible preoperative MRI marker that may help identify papillary hypothalamic craniopharyngiomas. These findings support further evaluation in multicenter studies before clinical implementation. Its recognition may contribute to imaging-based diagnostic strategies, including selection of patients for confirmatory biopsy, molecular testing, and subsequent targeted therapy in appropriate cases.
Study context
- Population
- Adults with hypothalamic craniopharyngiomas; sign evaluated by 6 independent clinicians blinded to histopathology
- Participants
- 61 adults
- Outcome
- Identification of papillary tumors
Methodological detailssingle-center, retrospective, blinded to histopathology
- Single-center
- Retrospective
- Blinded to histopathology
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity | Overall diagnostic accuracy |
|---|---|---|---|
| Polystyrene beads sign | 92% | 98% | 96% |
Polystyrene beads sign
Sensitivity92%
Specificity98%
Overall diagnostic accuracy96%
Further findings
Intra- and interrater reliability
- Intrarater reliability across 2 separate readings was high
- Interrater reliability among all 6 clinicians was excellent
- After a brief calibration session, the sign was consistently recognizable and distinguishable from enhancement patterns in adamantinomatous tumors
Original publication
The polystyrene beads sign: a simple MRI marker for the preoperative diagnosis of papillary hypothalamic craniopharyngiomas. Eur J Endocrinol. Published 22 June 2026. doi:10.
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