Diffusion-weighted imaging for predicting tumor consistency and extent of resection in patients with pituitary adenoma

Ding, Wei; Huang, Zheng; Zhou, Gaofeng; Li, Lang; Zhang, Mingyu; Li, Zhenyan

doi:10.1007/s10143-020-01469-y

Cited by 17 publications

(9 citation statements)

References 36 publications

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“…In the current study, the ADC 10th percentile derived from MEM was significantly lower in hard meningiomas than in soft tumours. Our result is consistent with several previous studies on meningiomas [ 10 , 11 ] and pituitary adenomas [ 29 ], which are the most explored intracranial tumours in preoperative tumour consistency prediction. However, there were also a few incoherent results.…”

Section: Discussionsupporting

confidence: 93%

Histogram analysis of mono-exponential, bi-exponential and stretched-exponential diffusion-weighted MR imaging in predicting consistency of meningiomas

Zheng,

Jiang,

Lin

et al. 2023

Cancer Imaging

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Background The consistency of meningiomas is critical to determine surgical planning and has a significant impact on surgical outcomes. Our aim was to compare mono-exponential, bi-exponential and stretched exponential MR diffusion-weighted imaging in predicting the consistency of meningiomas before surgery. Methods Forty-seven consecutive patients with pathologically confirmed meningiomas were prospectively enrolled in this study. Two senior neurosurgeons independently evaluated tumour consistency and classified them into soft and hard groups. A volume of interest was placed on the preoperative MR diffusion images to outline the whole tumour area. Histogram parameters (mean, median, 10th percentile, 90th percentile, kurtosis, skewness) were extracted from 6 different diffusion maps including ADC (DWI), D*, D, f (IVIM), alpha and DDC (SEM). Comparisons between two groups were made using Student’s t-Test or Mann-Whitney U test. Parameters with significant differences between the two groups were included for Receiver operating characteristic analysis. The DeLong test was used to compare AUCs. Results DDC, D* and ADC 10th percentile were significantly lower in hard tumours than in soft tumours (P ≤ 0.05). The alpha 90th percentile was significantly higher in hard tumours than in soft tumours (P < 0.02). For all histogram parameters, the alpha 90th percentile yielded the highest AUC of 0.88, with an accuracy of 85.10%. The D* 10th percentile had a relatively higher AUC value, followed by the DDC and ADC 10th percentile. The alpha 90th percentile had a significantly greater AUC value than the ADC 10th percentile (P ≤ 0.05). The D* 10th percentile had a significantly greater AUC value than the ADC 10th percentile and DDC 10th percentile (P ≤ 0.03). Conclusion Histogram parameters of Alpha and D* may serve as better imaging biomarkers to aid in predicting the consistency of meningioma.

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Section: Discussionsupporting

confidence: 93%

Histogram analysis of mono-exponential, bi-exponential and stretched-exponential diffusion-weighted MR imaging in predicting consistency of meningiomas

Zheng,

Jiang,

Lin

et al. 2023

Cancer Imaging

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“…A higher risk of hypopituitarism or hyponatremia, RR = 6.75 (95% CI 3.23, 14.07), has also been described in those patients with fibrous adenomas ( 33 ). Several authors have suggested that preoperative radiological features of the PA in the MRI could be useful to predict tumor consistency, especially when radiomic and machine learning on T2-weighted MRI ( 34 ), diffusion-weighted imaging ( 35 ), or MR elastography were employed ( 36 ).…”

Section: Discussionmentioning

confidence: 99%

Radiological Knosp, Revised-Knosp, and Hardy–Wilson Classifications for the Prediction of Surgical Outcomes in the Endoscopic Endonasal Surgery of Pituitary Adenomas: Study of 228 Cases

et al. 2022

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PurposeTo evaluate which radiological classification, Knosp, revised-Knosp, or Hardy–Wilson classification, is better for the prediction of surgical outcomes in the endoscopic endonasal transsphenoidal (EET) surgery of pituitary adenomas (PAs).MethodsThis is a retrospective study of patients with PAs who underwent EET PA resection for the first time between January 2009 and December 2020. Radiological cavernous sinus invasiveness was defined as a Knosp or revised-Knosp grade >2 or a grade E in the Hardy–Wilson classification.ResultsA total of 228 patients with PAs were included. Cavernous sinus invasion was evident in 35.1% and suprasellar extension was evident in 74.6%. Overall, surgical cure was achieved in 64.3% of patients. Surgical cure was lower in invasive PAs than in non-invasive PAs (28.8% vs. 83.1%, p < 0.0001), and the risk of major complications was higher (13.8% vs. 3.4%, p = 0.003). The rate of surgical cure decreased as the grade of Knosp increased (p < 0.001), whereas the risk of complications increased (p < 0.001). Patients with Knosp 3B PAs tended to achieve surgical cure less commonly than Knosp 3A PAs (30.0% vs. 56.0%, p = 0.164). Similar results were observed based on the invasion and extension of Hardy–Wilson classification (stage A–C 83.1% vs. E 28.8% p < 0.0001, grade 0–II 81.1% vs. III–IV 59.7% p = 0.008). The Knosp classification offered the greatest diagnostic accuracy for the prediction of surgical cure (AUC 0.820), whereas the invasion Hardy–Wilson classification lacked utility for this purpose (AUC 0.654).ConclusionThe Knosp classifications offer a good orientation for the estimation of surgical cure and the risk of complications in patients with PAs submitted to EET surgery. However, the invasion Hardy–Wilson scale lacks utility for this purpose.

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“…Tumor consistency is an important factor in surgical planning, as it affects resection relief and exposure to surgical operation morbidity [64][65][66]. Typically speaking, through the process of suction and curettage, tumors, usually with a soft consistency, are easily removed.…”

Section: -Tesla Magnetic Resonance Imaging In Predicting the Tumor Co...mentioning

confidence: 99%

New Progress in Imaging of Pituitary Diseases

Wu¹

2024

Frontiers in Neuroimaging

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In the last 20 years, there have been advances in imaging techniques for pituitary diseases. Magnetic resonance imaging (MRI) particularly presents high-quality structural images and the essential information needed to authorize surgery, radiation therapy, and/or drug therapy. These images can assist in monitoring long-term outcomes. Recent technological advances, such as the advent of 7-Tesla MRI, have been used for measuring tumor consistency in pituitary adenomas. Microadenomas and other pituitary incidentaloma have been more recognized in the presence of golden-angle radial sparse parallel imaging and conventional dynamic contrast-enhanced techniques. However, standard structural (anatomical) imaging, mainly in the form of MRI, acts inadequately to identify all tumors, especially microadenomas (< 1 cm diameter), recurrent adenomas, and several incidentalomas. In this respect, nuclear isotope (radionuclide) imaging promotes tumor detection beneficially. All these imaging improvements may play a central role in clinical practice, especially when considering diagnosis, differential diagnosis, or definitive intervention. They further form accurate diagnosis, advise surgery, and decrease the risk of disrupting normal pituitary function.

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Diffusion-weighted imaging for predicting tumor consistency and extent of resection in patients with pituitary adenoma

Cited by 17 publications

References 36 publications

Histogram analysis of mono-exponential, bi-exponential and stretched-exponential diffusion-weighted MR imaging in predicting consistency of meningiomas

Histogram analysis of mono-exponential, bi-exponential and stretched-exponential diffusion-weighted MR imaging in predicting consistency of meningiomas

Radiological Knosp, Revised-Knosp, and Hardy–Wilson Classifications for the Prediction of Surgical Outcomes in the Endoscopic Endonasal Surgery of Pituitary Adenomas: Study of 228 Cases

New Progress in Imaging of Pituitary Diseases

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