Alberto Conficoni1,2, Paola Feraco3,4, Diego Mazzatenta5, Matteo Zoli5, Sofia Asioli6, Corrado Zenesini7, Viscardo Paolo Fabbri3,6, Martino Cellerini2, Antonella Bacci2. 1. Department of Radiology, Neuroradiology Unit, Azienda Ospedaliero-Universitaria di Ferrara, Via Aldo Moro, 44124 Ferrara, Italy. 2. Department of Neuroradiology, Ospedale Bellaria, IRCCS Institute of Neurological Sciences of Bologna, Via Altura, 3; 40100 Bolgona, Italy. 3. Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Via S. Giacomo 14, 40138 Bologna, Italy. 4. Department of Neuroradiology, Ospedale S. Chiara, Azienda Provinciale per i Servizi Sanitari, Largo medaglie d'oro 9, 38122 , Trento, Italy. 5. Department of Biomedical and Neuromotor Sciences (DIBINEM) of Neurological Sciences of Bologna, Pituitary Unit, Center for the Diagnosis and Treatment of Hypothalamic and Pituitary Diseases, Bologna, Italy. 6. Section of Anatomic Pathology 'M. Malpighi', Bellaria Hospital, Bologna, Italy, Via Altura9; 40100 Bolgona, Italy. 7. Epidemiology and Statistics Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Abstract
OBJECTIVE: Pituitary macroadenomas (PAs) are usually defined as benign intracranial tumors. However, they may present local aggressive course. High Ki67 labelling index (LI) values have been related to an aggressive tumor behavior. A recent clinicopathological classification of PA based on local invasiveness and proliferation indexes, divided them in groups with different prognosis. We evaluated the utility of conventional MRI (cMRI) and diffusion-weighted imaging (DWI), in predicting the Ki67- LI according the clinicopathological classification. METHODS: 17 patients (12 M and 5 F) who underwent surgical removal of a PA were studied. cMRI features, quantification of T1W and T2W signal intensity, degree of contrast uptake (enhancement ratio, ER) and apparent diffusion coefficient (ADC) values were evaluated by using a 3 T scan. Statistics included Mann-Whitney test, Spearman's test, and receiver operating characteristic analysis. A value of p ≤ 0.05 was considered significant for all the tests. RESULTS: Negative correlations were observed between Ki-67 LI, ADCm (ρ = - 0.67, p value = 0.005) and ER values (ρ = -0.62; p = 0.008). ER values were significantly lower in the proliferative PA group (p = 0.028; p = 0.017). ADCm showed sensitivity and specificity of 90 and 85% respectively into predict Ki67-LI value. A value of ADCm ≤0, 711 x 10-6 mm2 emerged as a cut-off of a value of Ki67-LI ≥ 3%. CONCLUSION: Adding quantitative measures of ADC values to cMRI could be used routinely as a non-invasive marker of specific predictive biomarker of the proliferative activity of PA. ADVANCES IN KNOWLEDGE: Routinely use of DWI on diagnostic work-up of pituitary adenomas may help in establish the likely biological aggressive lesions.
OBJECTIVE: Pituitary macroadenomas (PAs) are usually defined as benign intracranial tumors. However, they may present local aggressive course. High Ki67 labelling index (LI) values have been related to an aggressive tumor behavior. A recent clinicopathological classification of PA based on local invasiveness and proliferation indexes, divided them in groups with different prognosis. We evaluated the utility of conventional MRI (cMRI) and diffusion-weighted imaging (DWI), in predicting the Ki67- LI according the clinicopathological classification. METHODS: 17 patients (12 M and 5 F) who underwent surgical removal of a PA were studied. cMRI features, quantification of T1W and T2W signal intensity, degree of contrast uptake (enhancement ratio, ER) and apparent diffusion coefficient (ADC) values were evaluated by using a 3 T scan. Statistics included Mann-Whitney test, Spearman's test, and receiver operating characteristic analysis. A value of p ≤ 0.05 was considered significant for all the tests. RESULTS: Negative correlations were observed between Ki-67 LI, ADCm (ρ = - 0.67, p value = 0.005) and ER values (ρ = -0.62; p = 0.008). ER values were significantly lower in the proliferative PA group (p = 0.028; p = 0.017). ADCm showed sensitivity and specificity of 90 and 85% respectively into predict Ki67-LI value. A value of ADCm ≤0, 711 x 10-6 mm2 emerged as a cut-off of a value of Ki67-LI ≥ 3%. CONCLUSION: Adding quantitative measures of ADC values to cMRI could be used routinely as a non-invasive marker of specific predictive biomarker of the proliferative activity of PA. ADVANCES IN KNOWLEDGE: Routinely use of DWI on diagnostic work-up of pituitary adenomas may help in establish the likely biological aggressive lesions.
Authors: Iulia Potorac; Patrick Petrossians; Adrian F Daly; Franck Schillo; Claude Ben Slama; Sonia Nagi; Mouna Sahnoun; Thierry Brue; Nadine Girard; Philippe Chanson; Ghaidaa Nasser; Philippe Caron; Fabrice Bonneville; Gérald Raverot; Véronique Lapras; François Cotton; Brigitte Delemer; Brigitte Higel; Anne Boulin; Stéphan Gaillard; Florina Luca; Bernard Goichot; Jean-Louis Dietemann; Albert Beckers; Jean-François Bonneville Journal: Endocr Relat Cancer Date: 2015-01-02 Impact factor: 5.678
Authors: Lorenzo Ugga; Renato Cuocolo; Domenico Solari; Elia Guadagno; Alessandra D'Amico; Teresa Somma; Paolo Cappabianca; Maria Laura Del Basso de Caro; Luigi Maria Cavallo; Arturo Brunetti Journal: Neuroradiology Date: 2019-08-02 Impact factor: 2.804
Authors: S Asioli; A Righi; M Iommi; C Baldovini; F Ambrosi; F Guaraldi; M Zoli; D Mazzatenta; M Faustini-Fustini; P Rucci; C Giannini; M P Foschini Journal: Eur J Endocrinol Date: 2019-02-01 Impact factor: 6.664
Authors: G Manenti; M Di Roma; S Mancino; D A Bartolucci; G Palmieri; R Mastrangeli; R Miano; E Squillaci; G Simonetti Journal: Radiol Med Date: 2008-04-02 Impact factor: 3.469
Authors: Susan K Hobbs; Gongyi Shi; Ron Homer; Griff Harsh; Scott W Atlas; Mark D Bednarski Journal: J Magn Reson Imaging Date: 2003-11 Impact factor: 4.813