{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T11:25:47Z","timestamp":1777461947516,"version":"3.51.4"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T00:00:00Z","timestamp":1734134400000},"content-version":"vor","delay-in-days":348,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Few studies have evaluated predictive factors of isolated pituitary stalk thickening (iPST) in children.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective study, radiology, endocrinology, and neuro-oncology databases were interrogated to identify patients with iPST between January 2000 and June 2019. A blinded, longitudinal assessment of MRIs was performed using quantitative, semi-quantitative, and qualitative metrics. Neuroimaging parameters were correlated to clinical parameters.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Forty-seven patients were identified, with 40 meeting the inclusion criteria. Median age at baseline MRI was 9.6 years (range 0.9\u201317.5) with median follow-up of 5.2 years (range 0.3\u201318.6). Twenty-five (63%) were female. Thirty-four (85%) had pituitary dysfunction, including 31 with central diabetes insipidus (cDI). cDI was not predictive of proliferative disease (PfD): 69% of those with presumed primary hypophysitis (PPH) versus 93% with PfD (P\u2005=\u2005.1). Fourteen (35%) patients were diagnosed with PfD (germinoma\u2005=\u20058, Langerhans cell histiocytosis\u2005=\u20055, lymphoma\u2005=\u20051) at median of 1.3 years (range 0.3\u20134.0) after initial MRI. Progressive thickening of the stalk over time was associated with PfD (86% vs 4% in PPH, P\u2005&amp;lt;\u2005.0001), as was thickening of the entire stalk (56% in PfD vs 27% in PPH, P\u2005&amp;lt;\u2005.0001) with different imaging trends over time observed in PfD versus PPH. A \u201csack of marbles\u201d appearance with heterogeneous enhancement on post-contrast imaging was associated with germinoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In this cohort, 35% of children with iPST were diagnosed with PfD. The association of cDI and PfD was not statistically significant. Progressive thickening of the entire stalk was predictive of PfD and a \u201csack of marbles\u201d pattern was found to be highly suggestive of germinoma.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/noajnl\/vdae214","type":"journal-article","created":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T22:03:59Z","timestamp":1734213839000},"source":"Crossref","is-referenced-by-count":2,"title":["Stalking the stalk: Isolated pituitary stalk thickening and predictive factors for proliferative disease"],"prefix":"10.1093","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4146-1511","authenticated-orcid":false,"given":"Julie","family":"Bennett","sequence":"first","affiliation":[{"name":"Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre , Toronto, Ontario ,","place":["Canada"]},{"name":"Division of Hematology\/Oncology, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liana","family":"Nobre","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology (iHOPE), Department of Pediatrics, Stollery Children\u2019s Hospital, University of Alberta , Edmonton, Alberta ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6832-6539","authenticated-orcid":false,"given":"Eric","family":"Bouffet","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oussama","family":"Abla","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bryan","family":"Maguire","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Afsaneh","family":"Amirabadi","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2618-4402","authenticated-orcid":false,"given":"Cynthia","family":"Hawkins","sequence":"additional","affiliation":[{"name":"Department of Paediatric Laboratory Medicine, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan D","family":"Wasserman","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7896-7049","authenticated-orcid":false,"given":"Birgit","family":"Ertl-Wagner","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, University of Toronto , Toronto, Ontario ,","place":["Canada"]},{"name":"Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children , Toronto, Ontario ,","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2112-5251","authenticated-orcid":false,"given":"Ute","family":"Bartels","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, The Hospital for Sick Children , Toronto, Ontario 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