Predictive role of dynamic contrast enhanced T1-weighted MR sequences in pre-surgical evaluation of macroadenomas consistency

Andrea Romano, Valeria Coppola, Mariangela Lombardi, Luigi Lavorato, D. Di Stefano, Emanuela Caroli, Maria Camilla Rossi Espagnet, F. Tavanti, Giuseppe Minniti, Giuseppe Trillò, Alessandro Bozzao

Research output: Contribution to journalArticle

Abstract

Purpose: Our hypothesis was that pituitary macroadenomas show different areas of consistency detectable by enhanced magnetic resonance imaging (MRI) with Dynamic study during gadolinium administration. Materials and methods: We analysed 21 patients with pituitary macroadenomas between June 2013 and June 2015. All patients underwent trans-sphenoidal surgery and neurosurgeon described macroadenomas consistency. Similarly, two neuroradiologists manually drew regions of interest (ROIs) inside the solid-appearing portions of macroadenoma and in the normal white matter both on dynamic and post-contrast acquisitions. The ratio between these ROIs, defined as Signal Intensity Ratio (SIR), allowed obtaining signal intensity curves over time on dynamic acquisition and a single value on post-contrast MRI. SIR values best differentiating solid from soft macroadenoma components were calculated and correlated with pathologic patterns. A two-sample T test and empiric receiver operating characteristic (ROC) curve of SIR was performed. Results: According to ROC analysis, the SIR value of 1.92, obtained by dynamic acquisition, best distinguished soft and hard components. All the specimens from soft components were characterized by high cellularity, high representation of vascularization and micro-haemorrhage and low percentage of collagen content. The reverse was evident in hard components. Conclusions: We demonstrated that dynamic MRI acquisition could distinguish with good accuracy macroadenomas consistency.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalPituitary
DOIs
Publication statusAccepted/In press - Oct 11 2016

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Keywords

  • Dynamic contrast-enhanced
  • MRI
  • Pituitary macroadenoma
  • Time-intensity curves
  • Tumoral consistency

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Romano, A., Coppola, V., Lombardi, M., Lavorato, L., Di Stefano, D., Caroli, E., Rossi Espagnet, M. C., Tavanti, F., Minniti, G., Trillò, G., & Bozzao, A. (Accepted/In press). Predictive role of dynamic contrast enhanced T1-weighted MR sequences in pre-surgical evaluation of macroadenomas consistency. Pituitary, 1-9. https://doi.org/10.1007/s11102-016-0760-z