Ultra-High-Field 7 T Magnetic Resonance Imaging Including Dynamic and Static Contrast-Enhanced T1-Weighted Imaging Improves Detection of Secreting Pituitary Microadenomas

Abstract

ObjectiveA prospective preoperative evaluation of 7 T ultra-high-field magnetic resonance imaging (MRI) in patients with suspected pituitary microadenomas for both adenoma detection and intrasellar localization compared with 3 T MRI was carried out.Materials and MethodsPatients underwent prospective preoperative standardized 3 and 7 T MRI. A distinct qualitative (lesion detection, intrasellar lesion location) and quantitative (lesion diameters, T1/T2 signal intensity ratio of the lesion to normal pituitary gland tissue) analysis was performed, along with an evaluation of image quality (IQ) regarding overall IQ, anatomical parameters, and artifacts; the findings of the qualitative analysis were compared with intraoperative findings and endocrinological outcomes.ResultsSixteen patients (mean age, 43 ± 16 years; 13 women) with pituitary microadenomas were included. Using 7 T MRI allowed the detection of 15 microadenomas—3 more than 3 T MRI. In addition, 7 T MRI allowed more precise lesion localization with 93.75% (15/16) agreement with intraoperative findings, compared with 75% (12/16) agreement using 3 T MRI. Lesion diameters showed no significant difference between 3 and 7 T MRI. T1 and T2 signal intensity ratio between microadenomas and normal pituitary gland tissue were higher in 7 T MRI than in 3 T MRI. The overall IQ and the IQ of each anatomical parameter of 7 T MRI were rated higher than those of 3 T MRI. No significant differences in susceptibility or head motion artifacts were observed between 3 and 7 T MRI; however, 7 T MRI was more susceptible to pulsation artifacts.ConclusionUltra-high-field MRI surpasses 3 T MRI in pituitary microadenoma detection and enables more precise delineation with higher correlation with intraoperative findings. Thus, 7 T sellar imaging is a promising option—especially in previously magnetic resonance–negative patients with endocrinologically confirmed hormone oversecretion—and helps reduce the need for invasive diagnostics.

Improved Detection of Cavernous Sinus Invasion of Pituitary Macroadenomas with Ultra-High-Field 7 T MRI

“…In the most recent study, Eisenhut et al evaluated 7 T MRI for microadenoma detection and intrasellar lesion localization in comparison to 3 T MRI. In their prospective analysis, ultra-high-field MRI also surpasses 3 T MRI as it allowed the detection of three additional microadenomas in previously magnetic-resonance-negative patients [ 17 ].…”

“…However, not only patients with microadenomas [ 17 ], but also patients with pituitary macroadenomas (PMA) could possibly benefit of ultra-high-field MRI—in particular regarding the identification and the extent of a CS infiltration [ 18 , 19 , 20 , 21 ]. Especially in secreting adenomas, this infiltration averts the neurosurgical aim of complete adenoma resection and hormonal normalization.…”

Delineation of Grade II and III Gliomas Investigated by 7T MRI: An Inter-Observer Pilot Study

“…MRI at current clinically used field strengths might pose a limitation with regard to revealing signal changes due to diffuse microscopic pathology. Structural 7T MRI was able to detect pituitary microadenomas in 93.75% whereas for 3T it was 75% in relation to intraoperative findings in a cohort of 16 patients [ 10 ]. A study conducted with 10 neuroradiologists found that the 7T structural scans compared to the 3T structural scans were more conspicuous in a variety of neurological diseases including neoplasm [ 11 ].…”

7 T MRI of the Cervical Neuroforamen

“…1 Compared with 1.5 and 3 T MRI, 7 T MRI provides an increased signalto-noise ratio, thus increasing spatiotemporal and spectral resolution, which enables better assessment of morphologic, biochemical, and functional details of musculoskeletal tissues. [2][3][4] Several studies have assessed different use cases for 7 T MRI in musculoskeletal imaging and found advantages compared with 3 T MRI. [5][6][7][8][9][10] Germann et al 5 recently demonstrated a higher sensitivity of dual-echo steady-state (DESS) knee imaging at 7 T for detecting meniscal and chondral calcifications in patients with calcium pyrophosphate deposition disease.…”

“…Over the last years, technical advancements of ultra-high field magnetic resonance imaging (MRI) at 7 T have contributed to its development as a valuable tool for musculoskeletal imaging 1 . Compared with 1.5 and 3 T MRI, 7 T MRI provides an increased signal-to-noise ratio, thus increasing spatiotemporal and spectral resolution, which enables better assessment of morphologic, biochemical, and functional details of musculoskeletal tissues 2–4 . Several studies have assessed different use cases for 7 T MRI in musculoskeletal imaging and found advantages compared with 3 T MRI 5–10 .…”