Kiyohisa Kamimura1, Masanori Nakajo2, Tomohide Yoneyama2, Manisha Bohara2, Ryota Nakanosono2, Shingo Fujio3, Takashi Iwanaga4, Marcel Dominik Nickel5, Hiroshi Imai6, Yoshihiko Fukukura2, Takashi Yoshiura2. 1. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. kiyohisa@m2.kufm.kagoshima-u.ac.jp. 2. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. 3. Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. 4. Clinical Engineering Department Radiation Section, Kagoshima University Hospital, Kagoshima, Japan. 5. Siemens Healthcare, Erlangen, Germany. 6. Siemens Healthcare K.K., Tokyo, Japan.
Abstract
PURPOSE: To evaluate the usefulness of high-temporal-resolution dynamic contrast-enhanced (DCE) MRI and quantitative pharmacokinetic analysis to differentiate the normal-appearing pituitary gland from a pituitary macroadenoma. MATERIALS AND METHODS: Twenty-seven patients with macroadenomas underwent preoperative DCE-MRI with a temporal resolution of 5 s using compressed sensing to obtain pharmacokinetic parameters. Two independent observers localized the normal-appearing pituitary gland on post-contrast T1-weighted images before and after referring to the corresponding Ktrans maps. Agreements between the localizations and intraoperative findings were evaluated using the kappa statistics. The Mann-Whitney U test was used to compare the pharmacokinetic parameters of the normal-appearing pituitary gland and adenoma. RESULTS: For both observers, the agreement between the MRI-based localization and the intraoperative findings increased after referring to the Ktrans maps (observer 1, 0.930-1; observer 2, 0.636-0.855). The normal-appearing pituitary gland had significantly higher Ktrans [/min] (1.50 ± 0.80 vs 0.58 ± 0.49, P < 0.0001), kep [/min] (3.19 ± 1.29 vs 2.15 ± 1.18, P = 0.0049), and ve (0.43 ± 0.15 vs 0.25 ± 0.17, P = 0.0003) than adenoma. CONCLUSION: High-temporal-resolution DCE-MRI and quantitative pharmacokinetic analysis help accurately localize the normal-appearing pituitary gland in patients with macroadenomas. The normal-appearing pituitary gland was characterized by higher Ktrans, kep, and ve than macroadenoma. Dynamic contrast-enhanced MRI with high-temporal-resolution using compressed sensing was used for quantitative pharmacokinetic analysis of pituitary macroadenomas. An observer study, the use of Ktrans maps improved accuracy in localizing the normal-appearing pituitary gland. As compared to an adenoma, the normal-appearing pituitary gland had significantly higher Ktrans, kep, and ve values.
PURPOSE: To evaluate the usefulness of high-temporal-resolution dynamic contrast-enhanced (DCE) MRI and quantitative pharmacokinetic analysis to differentiate the normal-appearing pituitary gland from a pituitary macroadenoma. MATERIALS AND METHODS: Twenty-seven patients with macroadenomas underwent preoperative DCE-MRI with a temporal resolution of 5 s using compressed sensing to obtain pharmacokinetic parameters. Two independent observers localized the normal-appearing pituitary gland on post-contrast T1-weighted images before and after referring to the corresponding Ktrans maps. Agreements between the localizations and intraoperative findings were evaluated using the kappa statistics. The Mann-Whitney U test was used to compare the pharmacokinetic parameters of the normal-appearing pituitary gland and adenoma. RESULTS: For both observers, the agreement between the MRI-based localization and the intraoperative findings increased after referring to the Ktrans maps (observer 1, 0.930-1; observer 2, 0.636-0.855). The normal-appearing pituitary gland had significantly higher Ktrans [/min] (1.50 ± 0.80 vs 0.58 ± 0.49, P < 0.0001), kep [/min] (3.19 ± 1.29 vs 2.15 ± 1.18, P = 0.0049), and ve (0.43 ± 0.15 vs 0.25 ± 0.17, P = 0.0003) than adenoma. CONCLUSION: High-temporal-resolution DCE-MRI and quantitative pharmacokinetic analysis help accurately localize the normal-appearing pituitary gland in patients with macroadenomas. The normal-appearing pituitary gland was characterized by higher Ktrans, kep, and ve than macroadenoma. Dynamic contrast-enhanced MRI with high-temporal-resolution using compressed sensing was used for quantitative pharmacokinetic analysis of pituitary macroadenomas. An observer study, the use of Ktrans maps improved accuracy in localizing the normal-appearing pituitary gland. As compared to an adenoma, the normal-appearing pituitary gland had significantly higher Ktrans, kep, and ve values.