Pituitary Macroadenomas: Preoperative Evaluation of Consistency with Diffusion-weighted MR Imaging—Initial Experience

Pierallini, A.; Caramia, Francesca; Falcone, Carlo; Tinelli, Emanuele; Paonessa, Amalia; Ciddio, Alessia Bernardo; Fiorelli, Marco; Bianco, Federico; Natalizi, Stefania; Ferrante, Luigi; Bozzao, L.

doi:10.1148/radiol.2383042204

Cited by 134 publications

(136 citation statements)

References 21 publications

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“…The application of DWI for the evaluation of pituitary adenomas however, is limited. Prior studies evaluating the role of ADC in the assessment of adenoma consistency for preoperative evaluation are conflicting [16][17][18]. Furthermore, there is minimal literature available regarding the use of The use of ADC in this study further helped delineate a subgroup of adenomas not identified on conventional MRI sequences.…”

Section: Discussionmentioning

confidence: 92%

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Apparent diffusion coefficient and pituitary macroadenomas: pre-operative assessment of tumor atypia

et al. 2016

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Section: Discussionmentioning

confidence: 92%

“…Specifically, the ADC value is often correlated with tumor cellularity and tumor grade [14]. Furthermore, multiple prior studies have demonstrated the role of DWI in the evaluation of pituitary adenomas, ranging from preoperative assessment of tumor consistency to correlation of ADC with the proliferative marker MIB-1 [14][15][16][17][18].…”

Section: Introductionmentioning

confidence: 99%

Apparent diffusion coefficient and pituitary macroadenomas: pre-operative assessment of tumor atypia

et al. 2016

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“…2017; 4(4):e14553. 5 ages (14). We found no significant difference between tumor to normal white matter T2-weighted signal intensity and tumor consistency during surgery.…”

Section: Discussionmentioning

confidence: 52%

“…High cellularity with a high nuclear to cytoplasm ratio and high collagen content can decrease signal intensity, whereas high extracellular free water increases SI on T2-weighted images (16 consistency. Pierallini et al demonstrated that adenomas with higher consistency displayed higher ADCs, whereas adenomas with a soft consistency showed higher cellularity and lower ADC values (14). They concluded that the ADC was positively correlated with the hardness of tumor.…”

Section: Discussionmentioning

confidence: 99%

“…We found no significant difference between tumor to normal white matter T2-weighted signal intensity and tumor consistency during surgery. Authors suggested that this discrepancy among results could be due to the effect of various factors on the T2-weighted signal intensity including tumor cellularity, nuclear to cytoplasmic ratio, free water in the extracellular space, and cystic component in the tumor (14,15). High cellularity with a high nuclear to cytoplasm ratio and high collagen content can decrease signal intensity, whereas high extracellular free water increases SI on T2-weighted images (16 consistency.…”

Section: Discussionmentioning

confidence: 99%

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Is There Any Congruity Between Tumor Consistency in Pituitary Macroadenomas and Preoperative Diffusion Weighted Imaging and Apparent Diffusion Coefficient (ADC) Map?

et al. 2017

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Background: Pituitary adenomas are the most common space-occupying lesions in the sellar region. Pituitary adenomas are usually soft, but 5 to 13% of macroadenomas are fibrous. The resection of firm tumors by curettage or suction is challenging. Therefore, preoperative knowledge of the pituitary adenomas consistency could help neurosurgeons plan more appropriate surgical procedures. In this regard, predicting fibrous adenomas by magnetic resonance imaging (MRI) is typically difficult and the results are controversial. We evaluated the correlation of pituitary adenoma consistency during tumor resection with preoperative diffusionweighted images (DWI) findings and apparent diffusion coefficient (ADC) values.

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Texture Analysis of High b‐Value Diffusion‐Weighted Imaging for Evaluating Consistency of Pituitary Macroadenomas

Zhang

Pan

et al. 2019

Magnetic Resonance Imaging

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Background: Preoperative evaluation of the consistency of pituitary macroadenomas is important for neurosurgeons to prepare the surgical plan. Purpose: To evaluate the diagnostic performance of texture analysis (TA) of diffusion-weighted imaging (DWI) at a standard b-value (b = 1000 s/mm 2 ) and a high b-value (b = 2000 s/mm 2 ) for their ability to assess the tumor consistency of pituitary macroadenomas. Study Type: Retrospective. Population/Subjects: Fifty patients with histologically confirmed pituitary macroadenomas were classified as soft (n = 37) or hard (n = 13) types. Field Strength/Sequence: Coronal T 2 -weighted imaging (T 2 WI), Readout Segmentation of Long Variable Echo-trains (RESOLVE) DWI at b = 1000 s/mm 2 and b = 2000 s/mm 2 were acquired with 3.0T MRI. Assessment: The corresponding apparent diffusion coefficient (ADC) maps (ADC 1000 and ADC 2000 ) were registered to T 2 WI. Regions of interest (ROIs) were manually drawn along the solid part of the tumor from the coregistered T 2 WI-ADC images. The texture parameters from T 2 WI, ADC 1000 , and ADC 2000 were acquired. Statistical Tests: The texture parameters were compared between the two types by using unpaired Student's t-test. Receiver operating characteristic (ROC) curves and logistic regression analyses were used to assess their diagnostic performance. Results: Significant differences in TA parameters of ADC 1000 and ADC 2000 were observed between soft and hard types (P < 0.05 for all), whereas the TA of T 2 WI resulted in no significant difference (P > 0.05 for all). TA of ADC 2000 provided a superior diagnostic performance compared with that of ADC 1000 (P = 0.038). A combination of mean value and entropy of ADC 2000 yielded an AUC, a sensitivity, and a specificity of 0.911, 78.4% and 92.3%, respectively. Data Conclusion: TA of ADC values were useful for assessing the tumor consistency of pituitary macroadenomas. ADC 2000 may facilitate better type discrimination. Level of Evidence: 3 Technical Efficacy Stage: 2 J. MAGN. RESON. IMAGING 2020;51:1507-1513.View this article online at wileyonlinelibrary.com.

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Pituitary Macroadenomas: Preoperative Evaluation of Consistency with Diffusion-weighted MR Imaging—Initial Experience

Abstract: Findings in this study suggest that DW MR images with ADC maps can provide information about the consistency of macroadenomas.

Cited by 134 publications

References 21 publications

Apparent diffusion coefficient and pituitary macroadenomas: pre-operative assessment of tumor atypia

Apparent diffusion coefficient and pituitary macroadenomas: pre-operative assessment of tumor atypia

Is There Any Congruity Between Tumor Consistency in Pituitary Macroadenomas and Preoperative Diffusion Weighted Imaging and Apparent Diffusion Coefficient (ADC) Map?

Texture Analysis of High b‐Value Diffusion‐Weighted Imaging for Evaluating Consistency of Pituitary Macroadenomas

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