Evolving approaches to craniopharyngioma diagnosis

Area of Science:

• Neurosurgery
• Oncology
• Radiology

Background:

• Craniopharyngiomas (CPs), despite benign histology, are aggressive brain tumors causing significant morbidity.
• Current diagnosis relies on invasive tissue sampling, hindering timely management.
• Advancements in molecular understanding are paving the way for targeted therapies.

Purpose of the Study:

• To review current and emerging noninvasive diagnostic approaches for craniopharyngiomas.
• To discuss challenges and progress in adopting noninvasive diagnostic strategies.
• To highlight the potential of imaging and liquid biopsies for CP management.

Main Methods:

• A narrative review of peer-reviewed literature from the past 20 years.
• Focus on craniopharyngiomas, histopathological and molecular diagnostics, radiomics, AI, and liquid biopsy.
• Analysis of current diagnostic standards and emerging noninvasive techniques.

Main Results:

• Pathological tissue confirmation via invasive biopsy remains the standard for CP diagnosis.
• Radiomics and AI show potential for noninvasive differentiation but face challenges in clinical translation (e.g., data limitations, lack of validation).
• Liquid biopsies show promise but require improved sensitivity for reliable detection of CP driver mutations.

Conclusions:

• Diagnostic innovation for CP is advancing with radiomics and liquid biopsies as potential noninvasive alternatives.
• Widespread clinical adoption is limited by the need for high-quality validation, larger datasets, and standardized protocols.
• Multicenter studies are crucial for integrating these emerging tools into clinical practice for improved CP management.