ArticleLa Radiologia medica2025
The "purfling sign": a new imaging marker for the diagnosis of primary CNS lymphoma.
Article in La Radiologia medica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Letter to the editor on "the purfling sign": a new ımaging marker for the diagnosis of primary CNS lymphoma.La Radiologia medica · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectivesTo investigate whether the "purfling sign," a new imaging marker, could distinguish primary central nervous system lymphoma (PCNSL) from brain gliomas, and its diagnosis value for preoperative identification of PCNSL.
methodsContrast-enhanced MR imaging features of 161 PCNSL and 161 glioma were evaluated by 2 independent neuroradiologists: (1) the presence/absence of the "purfling sign"; (2) the presence/absence of lesion necrosis and cystic changes; and (3) the heterogeneity of tumor parenchymal enhancement. Inter-rater agreement was assessed with Cohen's kappa (κ), and the diagnostic performance of the "purfling sign" in identifying PCNSL was investigated. Three separate institutional validation cohort (including 177 PCNSL and 177 glioma patients) was analyzed to validate the diagnostic performance of the "purfling sign."
resultsAmong the test set, the inter-rater agreement of the "purfling sign" was high (κ = 0.907), while that for the other features was only good [κ = 0.663-0.691]. The purfling sign was present in 89 (55.28%) lymphoma and 13 (8.07%) glioma cases with a specificity of 91.93%, a sensitivity of 55.28%, a positive predictive value (PPV) of 87.25%, and a negative predictive value (NPV) of 67.27% for the diagnosis of PCNSL. Furthermore, the tumors presenting with the "target sign" were all PCNSL (16/16,100%), with a specificity and PPV of 100%. Analysis with the validation cohort, 85.09% cases with a positive "purfling sign" were PCNSL (p < 0.0001; PPV = 85.09%, NPV = 66.67%, specificity = 90.40%, sensitivity = 54.80%).
conclusionsWith a robust inter-rater agreement, our study found that the "purfling sign" on enhanced MR represents a high specific imaging marker for the preoperative diagnosis of PCNSL. This noninvasive marker may aid in the guidance of the clinical diagnosis and treatment processes of PCNSL.
Indexed as
Identifiers
40350496What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.