{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T10:25:07Z","timestamp":1794219907747,"version":"4.8.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Nonfunctioning pituitary neuroendocrine tumors (NF-PitNETs) can recur despite gross-total resection (GTR), and the accurate prediction of tumor recurrence remains a major clinical challenge. In this study, authors aimed to evaluate the predictive value of the T2-weighted signal coefficient of variation (T2-CV) and develop an integrated prognostic nomogram for recurrence-free survival (RFS) in NF-PitNET.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Tumor heterogeneity was assessed using T2-weighted MRI. Clinical, radiological, and pathological variables were retrospectively collected on patients with a PitNET diagnosis between 2011 and 2024. Kaplan-Meier analysis was used for survival assessment of each parameter. A multivariate Cox proportional hazards model was employed to identify independent predictors of RFS, and a prognostic nomogram was subsequently developed based on these significant factors. The total score derived from the nomogram was used to stratify patients into distinct risk groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>This study included 596 patients with NF-PitNET who underwent GTR. Multivariate analysis identified four independent factors associated with shorter RFS: age &lt; 41 years, Knosp grade 3\u20134, T2-CV \u2265 0.442, and Ki-67 index \u2265 3% (all p &lt; 0.001). A nomogram incorporating these variables was developed and demonstrated superior predictive accuracy (area under the curve [AUC] = 0.801) compared to any single predictor alone (p &lt; 0.001). The nomogram achieved a concordance index of 0.82, demonstrating good calibration and strong clinical applicability. Its time-dependent receiver operating characteristic analysis further demonstrated AUC values of 0.85, 0.89, 0.84, 0.86, and 0.82 at 12, 24, 36, 48, and 60 months, respectively, indicating particular strength in short-term recurrence prediction. Furthermore, applying a cutoff score of 72.41, the nomogram effectively stratified patients into high- and low-risk groups, which were differentiated by significantly different median RFS (81.17 vs 99.93 months, respectively, HR 7.364, 95% CI 4.375\u201312.393, p &lt; 0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>T2-CV, a novel quantitative MRI parameter, serves as an independent predictor of RFS in patients following GTR of NF-PitNET. A nomogram integrating T2-CV with other key prognostic factors demonstrated high accuracy in identifying high-risk individuals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2026.1.jns251071","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T00:01:00Z","timestamp":1782259260000},"page":"645-654","source":"Crossref","is-referenced-by-count":1,"title":["A nomogram predicting postoperative recurrence risk in SF1\/TPIT nonfunctioning pituitary neuroendocrine tumors: integration of tumor heterogeneity quantification on T2-weighted imaging"],"prefix":"10.3171","volume":"145","author":[{"given":"Zhe","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing;"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing;"},{"name":"Department of Neurosurgery, Xuzhou Central Hospital, Xuzhou, Jiangsu Province;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengqing","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhua","family":"He","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing;"},{"name":"Department of Neurosurgery, Tongde Hospital, Hangzhou, Zhejiang Province;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanan","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing;"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaojie","family":"Yang","sequence":"additional","affiliation":[{"name":"Beijing Anding Hospital, Capital Medical University, Key Laboratory for Diagnosis and Treatment of Mental Disorders, National Clinical Research Center for Mental Disorders, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Peking University First Hospital, Beijing; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing;"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing;"},{"name":"China National Clinical Research Center for Neurological Diseases, Beijing;"},{"name":"Department of Neural Reconstruction, Beijing Neurosurgery Institute, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"16","key":"b1","series-title":"JAMA","first-page":"1386","article-title":"Diagnosis and management of pituitary adenomas: a review","volume":"329","author":"Tritos NA","year":"2023","unstructured":"Tritos NA, Miller KK. 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