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

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.

Imaging of pituitary tumors: an update with the 5th WHO Classifications—part 1. Pituitary neuroendocrine tumor (PitNET)/pituitary adenoma

“…Densely granulated tumors often have a weaker contrast enhancement than sparsely granulated tumors [ 83 ]. In a report examining the signal enhancement rate of PitNETs/pituitary adenomas relative to normal brain tissue (putamen) during the early (within 39 s) and delayed (195 s) phases of dynamic MRI, GH-producing tumors had lower contrast enhancement rates than other PitNETs/pituitary adenomas in both the early and delayed phases, suggesting that the signal enhancement rate on dynamic MRI may be a useful parameter for distinguishing GH-producing PitNETs/pituitary adenomas from other PitNETs/pituitary adenomas [ 84 ]. It has also been suggested that the signal enhancement curve of the tumor on dynamic MRI may be useful for diagnosis [ 85 , 86 ].…”

Assessment of the sequential time–signal enhancement curve of dynamic contrast-enhanced MRI might be effective in diagnosing growth hormone-producing pituitary adenomas

“…We appreciate the interest of Dr. Mori et al in our article [1] and we have read their letter with great interest. As described in their letter, our methodology was limited in terms of spatial and temporal resolution, so in this study, we used early (EER) and delayed (DER) tumour-to-normal-tissue enhancement ratios.…”

Predicting Subtype of Growth Hormone Pituitary Adenoma based on Magnetic Resonance Imaging Characteristics

“…However, the subtypes cannot be evaluated preoperatively and can only be confirmed by histopathology after an operation. Besides, there are few reports on the comprehensive evaluation of GH pituitary adenomas by combining multiple MR features 19,20 …”

“…Besides, there are few reports on the comprehensive evaluation of GH pituitary adenomas by combining multiple MR features. 19,20 This study analyzed the value of multisequence MRI in predicting the subtypes of GH adenomas. Significant differences were found in tumor size, T2 signal intensity, T2 rSI, enhancement degree, and invasiveness between DG and SG adenomas.…”