Magnetic resonance fingerprinting for preoperative differentiation between gonadotroph and non-gonadotroph pituitary macroadenomas

Abstract

Objectives To use magnetic resonance fingerprinting (MRF)-derived T1 and T2 values to differentiate gonadotroph from nongonadotroph pituitary macroadenomas based on the 2017 World Health Organization classification of pituitary adenomas. Methods A total of 57 patients with suspected pituitary macroadenomas were enrolled for analyses in this study between May 2018 and January 2020. Conventional magnetic resonance imaging (MRI) and MRF were performed in all patients before surgery using a 3-T MRI scanner. MRF-derived T1 and T2 values were compared between the gonadotroph and non-gonadotroph pituitary macroadenomas using a Mann-Whitney U test. The Knosp classification was used to evaluate cavernous sinus invasion by the adenomas. Receiver operating characteristic analyses were used to determine the diagnostic performance of T1 and T2 values. Results Quantitative T1 and T2 values yielded from MRF of gonadotroph pituitary macroadenomas were significantly higher than those of the non-gonadotroph pituitary macroadenomas (p < 0.001 and = 0.002, respectively). The AUC for the T2 value (0.888) was significantly greater than that for the T1 value (0.742) (p = 0.034). The AUC for combined T1 and T2 values was 0.885. Non-gonadotroph pituitary macroadenomas were more likely to invade the cavernous sinus than gonadotroph pituitary macroadenomas (55% vs 26%, p = 0.026). Conclusions MRF may help to preoperatively differentiate between gonadotroph and non-gonadotroph pituitary macroadenomas and may be useful in guiding the treatment of these adenomas. Key Points • Somatostatin receptor type 3 is the most abundant receptor subtype in gonadotroph pituitary adenomas.• Magnetic resonance fingerprinting may help to preoperatively differentiate between gonadotroph and non-gonadotroph pituitary macroadenomas. • Magnetic resonance fingerprinting shows potential for guiding the treatment of pituitary macroadenomas.

Magnetic Resonance Fingerprinting

“…49 Magnetic resonance fingerprinting has also been used to characterize nonglioma tumors such as meningiomas and pituitary macroadenomas. [50][51][52][53] Zhang et al 52 compared MRF-derived T1 and T2 values between pathologically confirmed subtypes of meningiomas and found that meningothelial meningiomas had significantly higher T1 and T2 values than transitional and fibrous meningiomas. Magnetic resonance fingerprinting T1 with MRF T2 showed ability to differentiate meningothelial meningiomas from other subtypes, whereas conventional weighted imaging and ADC values did not predict differentiation.…”

“…Magnetic resonance fingerprinting has also been used to characterize nonglioma tumors such as meningiomas and pituitary macroadenomas 50–53 . Zhang et al 52 compared MRF-derived T1 and T2 values between pathologically confirmed subtypes of meningiomas and found that meningothelial meningiomas had significantly higher T1 and T2 values than transitional and fibrous meningiomas.…”

“…In preoperative evaluation of pituitary macroadenomas, gonadotroph pituitary macroadenomas had significantly higher MRF-derived T1 and T2 values than nongonadotroph pituitary macroadenomas, and a combination of T1 and T2 could differentiate between the 2 subtypes. This distinction can have prognostic value, as cavernous sinus invasion is more likely with nongonadotroph pituitary macroadenomas 53 …”

“…This distinction can have prognostic value, as cavernous sinus invasion is more likely with nongonadotroph pituitary macroadenomas. 53 Because of flexibility in sequence designs and multiproperty mapping, MRF may be beneficial for radiation therapy treatment planning protocols for longitudinal assessment of changes in primary brain tumoral properties. 54 The feasibility of MRF has been demonstrated on both high-and low-field strength hybrid MR-guided linear accelerators used for radiation therapy.…”

Optimized multi‐axis spiral projection MR fingerprinting with subspace reconstruction for rapid whole‐brain high‐isotropic‐resolution quantitative imaging

“…Magnetic resonance fingerprinting (MRF) 1 is a rapid quantitative imaging technique for estimating multiple tissue parameters simultaneously and has attracted significant interests as a diagnostic tool in diseases in which the pathological changes are sensitive to related quantitative parameters. [2][3][4][5][6][7][8] The pulse sequence of MRF is usually designed to boost temporal incoherence by varying the acquisition parameters (e.g., flip angle [FA] and TR) and adding a preparatory module (e.g., inversion-preparation pulse and T 2 -preparation pulse 9 ). Studies have demonstrated the repeatability and reproducibility of MRF in both quantitative relaxometry and morphometry.…”