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Open Access 28-09-2024 | Pituitary Adenoma | Diagnostic Neuroradiology

Role of diffusion-weighted imaging in the diagnosis of pituitary region tumors

Authors: Adrian Korbecki, Justyna Wagel, Anna Zacharzewska-Gondek, Maja Gewald, Justyna Korbecka, Michał Sobański, Arkadiusz Kacała, Agata Zdanowicz-Ratajczyk, Maciej Kaczorowski, Agnieszka Hałoń, Grzegorz Trybek, Stylianos Kapetanakis, Joanna Bladowska

Published in: Neuroradiology

Abstract

Purpose

This study aimed to assess the role of Diffusion-Weighted Imaging (DWI) in routine pituitary Magnetic Resonance Imaging (MRI) protocols for distinguishing sellar and parasellar tumors, addressing the lack of clear guidelines in contemporary literature.

Methods

A retrospective analysis of 242 pituitary MRI scans with DWI sequences was conducted in a single-center study using a 1.5 T scanner and standard DWI sequence parameters. Measurements of both absolute and relative mean apparent diffusion coefficient (ADC) values, along with minimal ADC values within tumors, were performed. The adopted region of interest (ROI) based method used for these measurements was validated.

Results

Invasive pituitary adenomas exhibited significantly lower min ADC and min rADC than meningiomas, with optimal cut-off points of 0.64 (sensitivity 73%, specificity 82%) and 0.78 (sensitivity 73%, specificity 89%), respectively. Post-hemorrhagic pituitary adenomas demonstrated lower ADC values than adamantinomatous craniopharyngiomas, with an AUC of 0.893 for min rADC = 1.07, and Rathke’s Cleft Cysts with mucous content, AUC 0.8 for min rADC = 1.01. Specific differentiation with high sensitivity and specificity based on diffusion parameters was observed for these tumor groups. Cystic pituitary non-functional adenomas obtained significantly lower ADC values compared to the adamantinomatous type of craniopharyngiomas and serous Rathke’s Cleft Cysts (AUC up to 0.942).

Conclusions

The study concludes that integrating DWI into routine pituitary MRI protocols enhances diagnostic accuracy in distinguishing sellar and parasellar tumors. The short scan time of one minute makes DWI a valuable and precise tool, supporting its recommendation as a standard component of pituitary MRI examinations.

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Title: Role of diffusion-weighted imaging in the diagnosis of pituitary region tumors
Authors: Adrian Korbecki
Justyna Wagel
Anna Zacharzewska-Gondek
Maja Gewald
Justyna Korbecka
Michał Sobański
Arkadiusz Kacała
Agata Zdanowicz-Ratajczyk
Maciej Kaczorowski
Agnieszka Hałoń
Grzegorz Trybek
Stylianos Kapetanakis
Joanna Bladowska
Publication date: 28-09-2024
Publisher: Springer Berlin Heidelberg
Keywords: Pituitary Adenoma
Craniopharyngioma
Meningioma
Meningioma
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Neuroradiology
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI: https://doi.org/10.1007/s00234-024-03467-z

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