Benign notochordal cell tumours of the spine: imaging characteristics and longitudinal imaging follow-up
Kanbour, Ibrahim Uldin, Hasaam Howard, Kieran Hughes, Simon Botchu, Rajesh
Kanbour, Ibrahim
Uldin, Hasaam
Howard, Kieran
Hughes, Simon
Botchu, Rajesh
Abstract
Background: Benign notochordal cell tumours (BNCTs) are non-aggressive intraosseous lesions arising from notochordal remnants within the axial skeleton. This study aimed to evaluate their computed tomography (CT) and magnetic resonance imaging (MRI) features and to define how serial imaging follow-up can be used to monitor these lesions.
Methods: A retrospective review with institutional ethical approval included all patients diagnosed with spinal BNCTs at a tertiary orthopaedic oncology centre between June 2008 and October 2025. Imaging studies were reviewed by consensus of three fellowship-trained musculoskeletal radiologists. Lesions were assessed using CT and MRI for location, size, margins, presence of concerning features, and interval change on follow-up imaging.
Results: Nineteen patients were included (11 females, 8 males; mean age 44.6 years, range 16-66 years). All BNCTs were incidentally discovered, solitary, well-defined, intraosseous lesions located in the midline of the vertebral bodies, without cortical destruction or extraosseous components. Most were sacral (14/19, 73.7%). Mean maximal lesion size was 1.7 cm. On MRI, 18/19 lesions demonstrated homogeneous low-to-intermediate T1-weighted and high T2-weighted/STIR signal intensity. Internal microscopic fat was present in 9/12 cases. On CT, lesions typically presented with faint sclerosis (10/12). Four lesions with atypical imaging features underwent biopsy and were confirmed as BNCTs. Mean imaging follow-up was 34.2 months (range 1 month to 11 years). All lesions remained stable throughout follow-up.
Conclusions: Incidental spinal BNCTs demonstrate characteristic non-aggressive CT and MRI features and stability on longitudinal imaging follow-up. Lesions without concerning imaging features can be appropriately managed with interval imaging surveillance.
MIDER Authors
Affiliations
Royal Orthopaedic Hospital NHS Foundation Trust; University Hospitals Birmingham NHS Foundation Trust
Date
2026-05-30
Type
Article
Collections
Citation
Kanbour I, Uldin H, Howard K, Hughes S, Botchu R. Benign notochordal cell tumours of the spine: imaging characteristics and longitudinal imaging follow-up. Eur Spine J. 2026 May 30. doi: 10.1007/s00586-026-10023-1. Epub ahead of print.