High resolution pituitary gland MRI at 7.0 tesla: a clinical evaluation in Cushing’s disease

Rotte, Alexandra A. J. de; Groenewegen, Amy; Rutgers, D. R.; Witkamp, Theo D.; Zelissen, Pierre; Meijer, Frederick J. A.; Lindert, Erik J. van; Hermus, A.R.M.M.; Luijten, Peter R.; Hendrikse, Jeroen

doi:10.1007/s00330-015-3809-x

Cited by 46 publications

(31 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…19 In a later series of healthy subjects (six scanned at 7T, two of which were additionally scanned at 3T), Gizewski et al demonstrated excellent visualization of brain stem structures and exiting nerves at 7T, including structures that were not detectable at 3T, such as the vagal and glossopharyngeal nerves. 18 While de Rotte et al successfully demonstrated imaging of the pituitary gland and chemically confirmed microadenomas with 7T images, 10,12 their studies did not analyze the surrounding cavernous anatomy. To the best of the authors’ knowledge, no previous studies have demonstrated the visualization of the cranial nerves with 7T MRI as they course through the cavernous sinus in neither healthy subjects nor in patients with local pathology.…”

Section: Discussionmentioning

confidence: 99%

“…35,41 Two studies by De Rotte et al have demonstrated the feasibility of imaging the pituitary gland as well as improved detection of clinically suspected microadenomas at 7T MRI. 12-11 While these studies were the first to demonstrate the feasibility of imaging the pituitary gland and microadenomas at 7T, they did not include 3T images for comparison nor did they include analysis of the surrounding neural and vascular structures of most concern for surgical approaches to the sellar and parasellar spaces.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

et al. 2017

View full text Add to dashboard Cite

Background Successful endoscopic endonasal surgery for the resection of skull base tumors is reliant on preoperative imaging to delineate pathology from the surrounding anatomy. The increased signal-to-noise ratio afforded by 7T MRI can be used to increase spatial and contrast resolution, which may lend itself to improved imaging of skull base. In this study, we apply a 7T imaging protocol to patients with skull base tumors and compare the images to clinical standard of care. Methods Images were acquired at 7T on 11 patients with skull base lesions. Two neuroradiologists evaluated clinical 1.5T, 3T, and 7T scans for detection of intracavernous cranial nerves and ICA branches. Detection rates were compared. Images were utilized for surgical planning and uploaded to a neuronavigation platform and used to guide surgery. Results Image analysis yielded improved detection rates of cranial nerves and ICA branches at 7T. 7T images were successfully incorporated into preoperative planning and intraoperative neuronavigation. Conclusion Our study represents the first application of 7T MRI to the full neurosurgical workflow for endoscopic endonasal surgery. We detected higher rates of cranial nerves and ICA branches at 7T MRI compared to 3T and 1.5 T, and found that integration of 7T into surgical planning and guidance was feasible. These results suggest a potential for 7T MRI to reduce surgical complications. Future studies comparing standardized 7T, 3T, and 1.5 T MRI protocols in a larger number of patients are warranted to determine the relative benefit of 7T MRI for endonasal endoscopic surgical efficacy.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

et al. 2017

View full text Add to dashboard Cite

show abstract

“…One remaining prob-lem is very small pituitary adenomas that are impossible to identify using 3-T MRI. In the future, higher magnetic field MRI may resolve this problem [10].…”

Section: Limitations Of the Detectable Tumor Sizementioning

confidence: 99%

Outcomes of three-Tesla magnetic resonance imaging for the identification of pituitary adenoma in patients with Cushing’s disease

et al. 2019

View full text Add to dashboard Cite

Pituitary adenoma has been reported to be detectable in only 36-63% of Cushing's disease (CD) patients by magnetic resonance imaging (MRI). In this study, we investigate the outcomes and problems associated with tumor identification using 3-Tesla (3-T) MRI, which provides clearer images than ≤1.5-T MRI, in 115 patients who were initially diagnosed with CD. Before surgery, 31 macroadenomas (27%) and 54 microadenomas (47%) were identified by 3-T MRI, but pituitary adenoma was invisible on MRI in the remaining 30 cases (26%). The smallest tumor diameter amenable to a definitive diagnosis was 2 mm, and spoiled gradient-echo was the best sequence for diagnosing microadenomas. In 14 of 30 cases of MRI-invisible CD, the pituitary adenoma was identified during surgery. Nine of these 14 tumors that developed from outside the pituitary gland were retrospectively identified on MRI by comparison with surgical findings. The remaining 16 cases of MRI-invisible CD in which the pituitary adenoma was not identified during surgery involved partial hypophysectomy. Seven cases were hormonally remitted, but another nine cases experienced persistent disease after surgery. The sensitivity and specificity of the pituitary adenoma diagnosis in CD patients after the introduction of 3-T MRI were 80% and 100%, respectively. However, the sensitivity decreased to 72% when macroadenomas were excluded. Some adenomas associated with CD are still undetectable on 3-T MRI due to tumor size, location and intensity. However, sensitivity can be improved by monitoring tumors that develop outside the pituitary gland.

show abstract

“…15 Early reports suggesting feasibility and benefits of ultra-high field MRI over lower field techniques in pituitary pathology have been limited by small sample sizes and inability to statistically compare 7 T to lower field scans. 9,14 Furthermore, the utility of 7 T MRI has not been quantitatively examined in a homogenous cohort of pituitary adenoma patients. The purpose of the present study was to acquire preoperative 7 T MRI and quantitatively compare detailed neuroradiological findings for pituitary adenomas and adjacent skull base neurovascular structures to conventionl MRI.…”

Section: Introductionmentioning

confidence: 99%

Utility of 7 Tesla MRI for Preoperative Planning of Endoscopic Endonasal Surgery for Pituitary Adenomas

Rutland

Delman

Feldman

et al. 2019

J Neurol Surg B Skull Base

View full text Add to dashboard Cite

Object There is increasing interest in investigating the utility of 7 Tesla (7 T) magnetic resonance imaging (MRI) for imaging of skull base tumors. The present study quantifies visualization of tumor features and adjacent skull base anatomy in a homogenous cohort of pituitary adenoma patients. Methods Eighteen pituitary adenoma patients were scanned at 7 T in this prospective study. All patients had reference standard-of-care clinical imaging at either 3 T (7/18, 39%) or 1.5 T (11/18, 61%). Visualization of tumor features and conspicuity of arteries and cranial nerves (CNs) was rated by an expert neuroradiologist on 7 T and clinical field strength MRI. Overall image quality and severity of image artifacts were also characterized and compared. Results Ability to visualize tumor features did not differ between 7 T and lower field MRI. Cranial nerves III, IV, and VI were better detected at 7 T compared with clinical field strength scans. Cranial nerves III, IV, and VI were also better detected at 7 T compared with only 1.5 T, and CN III was better visualized at 7 T compared with 3 T MRI. The ophthalmic arteries and posterior communicating arteries (PCOM) were better detected at 7 T compared with clinical field strength imaging. The 7 T also provided better visualization of the ophthalmic arteries compared with 1.5 T scans. Conclusions This study demonstrates that 7 T MRI is feasible at the skull base and identifies various CNs and branches of the internal carotid artery that were better visualized at 7 T. The 7 T MRI may offer important preoperative information that can help to guide resection of pituitary adenoma and reduce operative morbidity.

show abstract

High resolution pituitary gland MRI at 7.0 tesla: a clinical evaluation in Cushing’s disease

Cited by 46 publications

References 29 publications

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

First Application of 7-T Magnetic Resonance Imaging in Endoscopic Endonasal Surgery of Skull Base Tumors

Outcomes of three-Tesla magnetic resonance imaging for the identification of pituitary adenoma in patients with Cushing’s disease

Utility of 7 Tesla MRI for Preoperative Planning of Endoscopic Endonasal Surgery for Pituitary Adenomas

Contact Info

Product

Resources

About