Modified colloid cyst risk score: a new tool for clinical decision-making in patients with colloid cysts.

Background: This study develops the Modified Colloid Cyst Risk Score (MCCRS), a novel, evidence-based tool designed to identify patients with colloid cysts at high risk for clinical deterioration and obstructive hydrocephalus.

Methods: A systematic review was conducted to identify clinical indicators associated with worsening outcomes in colloid cyst patients. The MCCRS was constructed through expert consensus utilizing the modified Delphi technique. Its validity and reliability were subsequently evaluated.

Results: The review included 34 studies that met inclusion criteria. The MCCRS comprises several key criteria, each assigned specific points to stratify patients into different risk categories. These factors include cyst size (0-2 points), location within a risk zone (0-2 points), symptom presence (0-2 points), growth rate (0-2 points), patient age (0-1 point), and FLAIR MRI hyperintensity (additional point). Total scores categorize patients: 0-2 indicates low risk, suggesting annual MRI follow-up; 3-5 indicates moderate risk, requiring more frequent monitoring; scores of 6 or higher denote high risk, warranting aggressive management or surgical intervention. The MCCRS demonstrated a sensitivity of 93% and specificity of 99% for predicting clinical deterioration or obstructive hydrocephalus. Its positive predictive value was 98%, and negative predictive value was 94%.

Conclusion: The MCCRS is a valid, reliable tool that integrates multiple risk factors to guide clinical decision-making in colloid cyst management. It facilitates personalized monitoring strategies and intervention planning to prevent adverse outcomes.