{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T17:45:39Z","timestamp":1789839939486,"version":"4.0.1"},"reference-count":43,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T00:00:00Z","timestamp":1757980800000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Spinal chordomas are rare, malignant bone tumors originating from notochordal remnants, primarily affecting the sacrum, clivus, and spine. Despite their low prevalence, they present significant diagnostic and therapeutic challenges due to their local aggressiveness, high recurrence rate, and imaging similarities to other tumors, such as chondrosarcomas. Advances in imaging technologies, particularly high\u2010resolution magnetic resonance imaging and computed tomography (CT), have improved the ability to visualize chordomas and enhance the precision of surgical planning. Additionally, newer imaging modalities, including diffusion\u2010weighted imaging and positron emission tomography\/CT, offer more refined diagnostic capabilities, though differentiation from other similar lesions remains difficult. Histologically, chordomas are marked by physaliphorous cells and a myxoid stroma, with the brachyury gene playing a key role in tumorigenesis and serving as a potential therapeutic target. The pathophysiology and molecular landscape of chordomas further complicate diagnosis and treatment. This review examines the current state of imaging advancements, challenges in diagnosis, and their impact on clinical management. It highlights the importance of combining various imaging modalities to improve diagnostic accuracy, aid surgical resection planning, and reduce recurrence. Additionally, it discusses the ongoing need for more targeted therapies and improved imaging techniques to optimize patient outcomes in spinal chordoma management.<\/jats:p>","DOI":"10.1111\/jon.70090","type":"journal-article","created":{"date-parts":[[2025,9,16]],"date-time":"2025-09-16T07:07:28Z","timestamp":1758006448000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Spinal and Sacral Chordomas: Overview With Imaging Review"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5266-1115","authenticated-orcid":false,"given":"Rebecca","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Radiology and Radiological Science Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Schick","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Science Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sasicha","family":"Manupipatpong","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Science Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gross","sequence":"additional","affiliation":[{"name":"Department of Pathology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanxuan","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Lubelski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin J.","family":"Redmond","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Majid","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Radiology and Radiological Science Johns Hopkins Hospital  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3340\/jkns.2016.0505.011"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.02.109"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2016.0138"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000134306"},{"issue":"4","key":"e_1_2_10_6_1","first-page":"e1137","article-title":"Update on the Notochord Including Its Embryology, Molecular Development, and Pathology: A Primer for the Clinician","volume":"9","author":"Ramesh T.","year":"2017","journal-title":"Cureus"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10143-016-0753-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B5.20365"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3171\/2017.7.SPINE17668"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-804257-1.00003-7"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-013-2888-9"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2015.02.009"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11060-024-04807-y"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10051054"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-142X.2011.00522.x"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00018-015-1897-z"},{"key":"e_1_2_10_17_1","first-page":"451","volume-title":"WHO Classification of Tumours Editorial Board","author":"Tirabosco R.","year":"2020"},{"key":"e_1_2_10_18_1","first-page":"454","volume-title":"WHO Classification of Tumours Editorial Board","author":"Tirabosco R.","year":"2020"},{"key":"e_1_2_10_19_1","first-page":"456","volume-title":"WHO Classification of Tumours Editorial Board","author":"Nielsen G. 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