Top

Published in:

01-08-2021 | Pituitary Adenoma | Original Article

The utility of dynamic MRI in differentiating the hormone-producing ability of pituitary adenomas

Authors: Taishi Amano, Tomohiko Masumoto, Hiroyoshi Akutsu, Noriaki Sakamoto, Sodai Hoshiai, Kensaku Mori, Takahito Nakajima

Published in: Japanese Journal of Radiology | Issue 8/2021

Abstract

Purpose

To investigate the relationship between dynamic magnetic resonance imaging (MRI) findings and hormonal activity in pituitary adenomas.

Methods

We retrospectively evaluated the dynamic MRI findings in 244 patients with pathologically confirmed pituitary adenomas and a diagnosis of clinically active prolactin (PRL)-producing adenomas. Among the 244 pituitary adenomas, 55, 16, 6, and 4 produced growth hormone (GH), PRL, adrenocorticotropic hormone, and thyroid-stimulating hormone, respectively, while 163 were non-functioning (NF) adenomas. For each adenoma, we calculated the washout rate (WR) and early (EER) and delayed (DER) tumour-to-normal-tissue enhancement ratios.

Results

The respective mean values of the WR, EER, and DER were 9.4%, 75.2%, and 64.5% for GH-producing adenomas; 6.2%, 117.1%, and 106.2% for PRL-producing adenomas; and 5.4%, 116.7%, and 108.7% for NF adenomas. GH-producing adenomas had significantly lower EER and DER values than PRL-producing (P < 0.001) and NF adenomas (P < 0.001). In ROC analysis of GH-producing and non-GH-producing adenomas, the areas under the curves of WR, EER, and DER were 0.593, 0.825, and 0.857, respectively.

Conclusion

There are differences in dynamic MRI features between GH-producing and non-GH-producing adenomas, which suggests that EER and DER may be useful for diagnosing GH-producing adenomas.

Miki Y, Matsuo M, Nishizawa S, Kuroda Y, Keyaki A, Makita Y, Kawamura J. Pituitary adenomas and normal pituitary tissue: enhancement patterns on gadopentetate-enhanced MR imaging. Radiology. 1990;177:35–8. https://doi.org/10.1148/radiology.177.1.2399335.CrossRefPubMed

Kucharczyk W, Bishop JE, Plewes DB, Keller MA, George S. Detection of pituitary microadenomas: comparison of dynamic keyhole fast spin-echo, unenhanced, and conventional contrast-enhanced MR imaging. Am J Roentgenol. 1994;163:671–9. https://doi.org/10.2214/ajr.163.3.8079866.CrossRef

Yuh WTC, Fisher DJ, Nguyen HD, Tali ET, Gao F, Simonson TM, Schlechte JA. Sequential MR enhancement pattern in normal pituitary gland and in pituitary adenoma. Am J Neuroradiol. 1994;15:101–8.PubMed

Bonneville JF, Bonneville F, Cattin F. Magnetic resonance imaging of pituitary adenomas. Eur Radiol. 2005;15:543–8. https://doi.org/10.1007/s00330-004-2531-x.CrossRefPubMed

Singh M, Verma A, Sharma N. An optimized cascaded stochastic resonance for the enhancement of brain MRI. IRBM. 2018;39:334–42. https://doi.org/10.1016/j.irbm.2018.08.002.CrossRef

Sen R, Sen C, Pack J, Block KT, Golfinos JG, Prabhu V, et al. Role of high-resolution dynamic contrast-enhanced MRI with golden-angle radial sparse parallel reconstruction to identify the normal pituitary gland in patients with macroadenomas. Am J Neuroradiol. 2017;38:1117–21. https://doi.org/10.3174/ajnr.A5244.CrossRefPubMedPubMedCentral

Lundin P, Nyman R, Burman P, Lundberg PO, Muhr C. MRI of pituitary macroadenomas with reference to hormonal activity. Neuroradiology. 1992;34:43–51. https://doi.org/10.1007/BF00588432.CrossRefPubMed

Marro B, Zouaoui A, Sahel M, Crozat N, Gerber S, Sourour N, et al. MRI of pituitary adenomas in acromegaly. Neuroradiology. 1997;39:394–9. https://doi.org/10.1007/s002340050431.CrossRefPubMed

Hagiwara A, Inoue Y, Wakasa K, Haba T, Tashiro T, Miyamoto T. Comparison of growth hormone-producing and non-growth hormone-producing pituitary adenomas: imaging characteristics and pathologic correlation. Radiology. 2003;228:533–8. https://doi.org/10.1148/radiol.2282020695.CrossRefPubMed

10.

Guo Q, Young WF, Erickson D, Erickson B. Usefulness of dynamic MRI enhancement measures for the diagnosis of ACTH-producing pituitary adenomas. Clin Endocrinol (Oxf). 2015;82:267–73. https://doi.org/10.1111/cen.12475.CrossRef

11.

Kanou Y, Arita K, Kurisu K, Tomohide A, Iida K. Clinical implications of dynamic MRI for pituitary adenomas: clinical and histologic analysis. J Clin Neurosci. 2002;9:659–63. https://doi.org/10.1054/jocn.2002.1141.CrossRefPubMed

12.

Romano A, Coppola V, Lombardi M, Lavorato L, Di Stefano D, Caroli E, et al. Predictive role of dynamic contrast enhanced T1-weighted MR sequences in pre-surgical evaluation of macroadenomas consistency. Pituitary. 2017;20:201–9. https://doi.org/10.1007/s11102-016-0760-z.CrossRefPubMed

13.

Vidal S, Kovacs K, Horvath E, Scheithauer BW, Kuroki T, Lloyd RV. Microvessel density in pituitary adenomas and carcinomas. Virchows Arch. 2001;438:595–602. https://doi.org/10.1007/s004280000373.CrossRefPubMed

14.

Di Ieva A, Grizzi F, Ceva-Grimaldi G, Russo C, Gaetani P, Aimar E, et al. Fractal dimension as a quantitator of the microvasculature of normal and adenomatous pituitary tissue. J Anat. 2007;211:673–80. https://doi.org/10.1111/j.1469-7580.2007.00804.x.CrossRefPubMedPubMedCentral

15.

Takano S, Akutsu H, Hara T, Yamamoto T, Matsumura A. Correlations of vascular architecture and angiogenesis with pituitary adenoma histotype. Int J Endocrinol. 2014;2014:989574. https://doi.org/10.1155/2014/989574.CrossRefPubMedPubMedCentral

16.

Wei L, Lin SA, Fan K, Xiao D, Hong J, Wang S. Relationship between pituitary adenoma texture and collagen content revealed by comparative study of MRI and pathology analysis. Int J Clin Exp Med. 2015;8:12898–905.PubMedPubMedCentral

Title: The utility of dynamic MRI in differentiating the hormone-producing ability of pituitary adenomas
Authors: Taishi Amano
Tomohiko Masumoto
Hiroyoshi Akutsu
Noriaki Sakamoto
Sodai Hoshiai
Kensaku Mori
Takahito Nakajima
Publication date: 01-08-2021
Publisher: Springer Singapore
Keywords: Pituitary Adenoma
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Published in: Japanese Journal of Radiology / Issue 8/2021
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI: https://doi.org/10.1007/s11604-021-01121-9

At a glance: The STEP trials

Springer Medicine

The utility of dynamic MRI in differentiating the hormone-producing ability of pituitary adenomas

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2021

Value of ultrafast and standard dynamic contrast-enhanced magnetic resonance imaging in the evaluation of the presence and extension of residual disease after neoadjuvant chemotherapy in breast cancer

Tumor volume-adapted SUVN as an alternative to SUVpeak for quantification of small lesions in PET/CT imaging: a proof-of-concept study

Congenital anomalies causing hemato/hydrocolpos: imaging findings, treatments, and outcomes

Ground-glass opacity (GGO): a review of the differential diagnosis in the era of COVID-19

Magnetic resonance imaging assessment of aortic dilatation and distensibility in 269 patients with repaired tetralogy of Fallot

Usefulness of computed tomography for hospitalized adult patients with fever to investigate cause of fever: single-center, retrospective cohort study