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Neuroradiology

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Open Access 22-09-2023 | Magnetic Resonance Imaging | Diagnostic Neuroradiology

What to report in sellar tumor MRI? A nationwide survey among German pituitary surgeons, radiation oncologists, and endocrinologists

Authors: Torge Huckhagel, Christian Riedel, Jörg Flitsch, Roman Rotermund

Published in: Neuroradiology | Issue 11/2023

Abstract

Purpose

While MRI has become the imaging modality of choice in the diagnosis of sellar tumors, no systematic attempt has yet been made to align radiological reporting of findings with the information needed by the various medical disciplines dealing with these patients. Therefore, we aimed to determine the prevailing preferences in this regard through a nationwide expert survey.

Methods

First, an interdisciplinary literature-based catalog of potential reporting elements for sellar tumor MRI examinations was created. Subsequently, a web-based survey regarding the clinical relevance of these items was conducted among board certified members of the German Society of Neurosurgery, German Society of Radiation Oncology, and the Pituitary Working Group of the German Society of Endocrinology.

Results

A total of 95 experts (40 neurosurgeons, 28 radiation oncologists, and 27 endocrinologists) completed the survey. The description of the exact tumor location, size, and involvement of the anatomic structures adjacent to the sella turcica (optic chiasm, cavernous sinus, and skull base), occlusive hydrocephalus, relationship to the pituitary gland and infundibulum, and certain structural characteristics of the mass (cyst formation, hemorrhage, and necrosis) was rated most important (> 75% agreement). In contrast, the characterization of anatomic features of the nasal cavity and sphenoid sinus as well as the findings of advanced MRI techniques (e.g., perfusion and diffusion imaging) was considered relevant by less than 50% of respondents.

Conclusion

To optimally address the information needs of the interdisciplinary treatment team, MRI reports of sellar masses should primarily focus on the accurate description of tumor location, size, internal structure, and involvement of adjacent anatomic compartments.

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Ostrom QT, Gittleman H, Fulop J et al (2015) CBTRUS statistical report: primary brain and central nervous system tumors diagnosed in the United States in 2008-2012. Neuro Oncol 17:iv1–iv62. https://doi.org/10.1093/neuonc/nov189 CrossRefPubMedPubMedCentral

Bresson D, Herman P, Polivka M, Froelich S (2016) Sellar lesions/pathology. Otolaryngol Clin North Am 49:63–93. https://doi.org/10.1016/j.otc.2015.09.004 CrossRefPubMed

Bonneville JF (2016) Magnetic resonance imaging of pituitary tumors. In: Buchfelder M, Guaraldi F (eds) Imaging in endocrine disorders, vol 45. S. Karger, AG. https://doi.org/10.1159/000442327

Bashari WA, Senanayake R, Fernández-Pombo A et al (2019) Modern imaging of pituitary adenomas. Pract Res Clin Endocrinol Metabol 33:101278. https://doi.org/10.1016/j.beem.2019.05.002 CrossRef

Portocarrero-Ortiz L, Bonifacio-Delgadillo D, Sotomayor-González A et al (2010) A modified protocol using half-dose gadolinium in dynamic 3-Tesla magnetic resonance imaging for detection of ACTH-secreting pituitary tumors. Pituitary 13:230–235. https://doi.org/10.1007/s11102-010-0222-y CrossRefPubMed

Karimian-Jazi K (2019) Hypophysentumoren. Radiologe 59:982–991. https://doi.org/10.1007/s00117-019-0570-1 CrossRefPubMed

Bonneville F, Roques M, Carletti F (2019) Tumors of the sellar and parasellar region. In: Barkhof F, Jager R, Thurnher M, Rovira Cañellas A (eds) Clinical Neuroradiology. Springer International Publishing, Cham, pp 1–32

Gore A, Hoch MJ, Shu H-KG et al (2019) Institutional implementation of a structured reporting system: our experience with the brain tumor reporting and data system. Acad Radiol 26:974–980. https://doi.org/10.1016/j.acra.2018.12.023 CrossRefPubMed

Weinberg BD, Gore A, Shu H-KG et al (2018) Management-based structured reporting of posttreatment glioma response with the brain tumor reporting and data system. J Am Coll Radiol 15:767–771. https://doi.org/10.1016/j.jacr.2018.01.022 CrossRefPubMed

10.

Kelley K (2003) Good practice in the conduct and reporting of survey research. Int J Qual Health Care 15:261–266. https://doi.org/10.1093/intqhc/mzg031 CrossRefPubMed

11.

Osborn AG (2020)Essentials of Osborn’s brain: a fundamental guide for residents and fellows. Elsevier

12.

Kumar J, Kumar A, Sharma R, Vashisht S (2007) Magnetic resonance imaging of sellar and suprasellar pathology: a pictorial review. Curr Probl Diagn Radiol 36:227–236. https://doi.org/10.1067/j.cpradiol.2007.04.004 CrossRefPubMed

13.

Evanson J (2020) Radiology of the Pituitary. In: Feingold KR, Anawalt B, Blackman MR, Boyce A, Chrousos G, Corpas E, de Herder WW, Dhatariya K, Dungan K, Hofland J, Kalra S, Kaltsas G, Kapoor N, Koch C, Kopp P, Korbonits M, Kovacs CS, Kuohung W, Laferrère B, Levy M, McGee EA, McLachlan R, New M, Purnell J, Sahay R, Shah AS, Singer F, Sperling MA, Stratakis CA, Trence DL, Wilson DP (eds). Endotext [Internet]. MDText.com, Inc.; 2000, South Dartmouth, MA

14.

Dhillon RS, King JA, Goldschlager T, Wang YY (2018) Synoptic reporting of pituitary magnetic resonance imaging: pituitary magnetic resonance imaging. ANZ J Surg 88:460–463. https://doi.org/10.1111/ans.14489 CrossRefPubMed

15.

Mamlouk MD, Chang PC, Saket RR (2018) Contextual radiology reporting: a new approach to neuroradiology structured templates. AJNR Am J Neuroradiol 39(8):1406–1414. https://doi.org/10.3174/ajnr.A5697 CrossRefPubMedPubMedCentral

16.

Powell DK, Silberzweig JE (2015) State of structured reporting in radiology, a survey. Acad Radiol 22:226–233. https://doi.org/10.1016/j.acra.2014.08.014 CrossRefPubMed

17.

Borgen L, Stranden E (2014) Radiation knowledge and perception of referral practice among radiologists and radiographers compared with referring clinicians. Insights Imaging 5:635–640. https://doi.org/10.1007/s13244-014-0348-y CrossRefPubMedPubMedCentral

18.

Grieve FM, Plumb AA, Khan SH (2010) Radiology reporting: a general practitioner’s perspective. BJR 83:17–22. https://doi.org/10.1259/bjr/16360063 CrossRefPubMedPubMedCentral

19.

Koczwara B, Tie M, Esterman A (2003) Are radiologists meeting the needs of Australian medical oncologists? Results of a national survey: Radiology service needs in oncology. Australas Radiol 47:268–273. https://doi.org/10.1046/j.1440-1673.2003.01179.x CrossRefPubMed

20.

Boll DT, Rubin GD, Heye T, Pierce LJ (2017) Affinity chart analysis: a method for structured collection, aggregation, and response to customer needs in radiology. Am J Roentgenol 208:W134–W145. https://doi.org/10.2214/AJR.16.16673 CrossRef

21.

Huckhagel T, Riedel C (2022) MRT-Befundung hirneigener Tumoren: Was neuroonkologisch tätige Kliniker vom Radiologen erwarten. Radiologie 62:683–691. https://doi.org/10.1007/s00117-022-01014-6 CrossRefPubMed

22.

Larson DB, Towbin AJ, Pryor RM, Donnelly LF (2013) Improving consistency in radiology reporting through the use of department-wide standardized structured reporting. Radiology 267:240–250. https://doi.org/10.1148/radiol.12121502 CrossRefPubMed

23.

Jaursch-Hancke C, Deutschbein T, Knappe UJ et al (2021) The interdisciplinary management of newly diagnosed pituitary tumors. Dtsch Arztebl Int. https://doi.org/10.3238/arztebl.m2021.0015 CrossRefPubMedPubMedCentral

24.

Buchfelder M, Schlaffer SM, Zhao Y (2019) The optimal surgical techniques for pituitary tumors. Pract Res Clin Endocrinol Metabol 33:101299. https://doi.org/10.1016/j.beem.2019.101299 CrossRef

25.

Sharma RK, Irace AL, Overdevest JB, Gudis DA (2022) Carotid artery injury in endoscopic endonasal surgery: risk factors, prevention, and management. World J Otorhinolaryngol-head neck Surg 8:54–60. https://doi.org/10.1002/wjo2.7 CrossRefPubMedPubMedCentral

26.

García-Garrigós E, Arenas-Jiménez JJ, Monjas-Cánovas I et al (2015) Transsphenoidal approach in endoscopic endonasal surgery for skull base lesions: what radiologists and surgeons need to know. Radiographics 35:1170–1185. https://doi.org/10.1148/rg.2015140105 CrossRefPubMed

27.

Flanders AE, Jordan JE (2019) The ASNR-ACR-RSNA common data elements project: what will it do for the house of neuroradiology? AJNR Am J Neuroradiol 40:14–18. https://doi.org/10.3174/ajnr.A5780 CrossRefPubMedPubMedCentral

28.

ACR-RSNA RadElement Common Data Elements (CDEs). https://www.radelement.org/home/sets. Accessed 20 Jun 2023

29.

Bonneville J-F (2019) A plea for the T2W MR sequence for pituitary imaging. Pituitary 22:195–197. https://doi.org/10.1007/s11102-018-0928-9 CrossRefPubMed

30.

Wen PY, Macdonald DR, Reardon DA et al (2010) Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. JCO 28:1963–1972. https://doi.org/10.1200/JCO.2009.26.3541 CrossRef

31.

Wen PY, Chang SM, Van den Bent MJ et al (2017) Response assessment in neuro-oncology clinical trials. JCO 35:2439–2449. https://doi.org/10.1200/JCO.2017.72.7511 CrossRef

32.

Imber BS, Lin AL, Zhang Z et al (2019) Comparison of radiographic approaches to assess treatment response in pituitary adenomas: is RECIST or RANO good enough? J Endocr Soc 3:1693–1706. https://doi.org/10.1210/js.2019-00130 CrossRefPubMedPubMedCentral

33.

Hardy J, Vezina JL (1976) Transsphenoidal neurosurgery of intracranial neoplasm. Adv Neurol 15:261–273 PubMed

34.

Mooney M, Hardesty D, Sheehy J et al (2017) Rater reliability of the Hardy classification for pituitary adenomas in the magnetic resonance imaging era. J Neurol Surg B 78:413–418. https://doi.org/10.1055/s-0037-1603649 CrossRef

35.

DiBiase SJ, Kwok Y, Yovino S et al (2004) Factors predicting local tumor control after gamma knife stereotactic radiosurgery for benign intracranial meningiomas. Int J Radiat Oncol *Biology* Physics 60:1515–1519. https://doi.org/10.1016/j.ijrobp.2004.05.073 CrossRef

36.

Sotoudeh H (2010) A review on dural tail sign. WJR 2:188. https://doi.org/10.4329/wjr.v2.i5.188 CrossRefPubMedPubMedCentral

37.

Piper K, Yu S, Taghvaei M et al (2022) Radiation of meningioma dural tail may not improve tumor control rates. Front Surg 9:908745. https://doi.org/10.3389/fsurg.2022.908745 CrossRefPubMedPubMedCentral

38.

Chen CC, Carter BS, Wang R et al (2016) Congress of neurological surgeons systematic review and evidence-based guideline on preoperative imaging assessment of patients with suspected nonfunctioning pituitary adenomas. Neurosurgery 79:E524–E526. https://doi.org/10.1227/NEU.0000000000001391 CrossRefPubMed

39.

Cho KR, Jo K-I, Shin HJ (2013) Bromocriptine therapy for the treatment of invasive prolactinoma: the single institute experience. Brain Tumor Res Treat 1:71. https://doi.org/10.14791/btrt.2013.1.2.71 CrossRefPubMedPubMedCentral

40.

Huang RY, Bi WL, Weller M et al (2019) Proposed response assessment and endpoints for meningioma clinical trials: report from the Response Assessment in Neuro-Oncology Working Group. Neuro Oncol 21:26–36. https://doi.org/10.1093/neuonc/noy137 CrossRefPubMed

41.

S2k-Leitlinie Diagnostik und Therapie klinisch hormoninaktiver Hypophysentumoren Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) AWMF registration number: 089-002. https://www.awmf.org. Accessed 12 Apr 2021

42.

Netuka D, Grotenhuis A, Foroglou N et al (2022) Pituitary adenoma surgery survey: neurosurgical centers and pituitary adenomas. Int J Endocrinol 2022:1–7. https://doi.org/10.1155/2022/7206713 CrossRef

Title: What to report in sellar tumor MRI? A nationwide survey among German pituitary surgeons, radiation oncologists, and endocrinologists
Authors: Torge Huckhagel
Christian Riedel
Jörg Flitsch
Roman Rotermund
Publication date: 22-09-2023
Publisher: Springer Berlin Heidelberg
Keywords: Magnetic Resonance Imaging
Magnetic Resonance Imaging
Meningioma
Meningioma
Published in: Neuroradiology / Issue 11/2023
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-023-03222-w

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What to report in sellar tumor MRI? A nationwide survey among German pituitary surgeons, radiation oncologists, and endocrinologists

Abstract

Purpose

Methods

Results

Conclusion

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