Usefulness of Dual-Energy Computed Tomography Imaging in the Differential Diagnosis of Sellar Meningiomas and Pituitary Adenomas: Preliminary Report

Wu, Lian‐Ming; Li, Yu-Lai; Yin, Yuhua; Hou, Guanyu; Zhu, Rong; Hua, Xiao-Lan; Xu, Jianrong; Chen, Zengai

doi:10.1371/journal.pone.0090658

Cited by 22 publications

(18 citation statements)

References 8 publications

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“…The measured iodine concentration divided by iodine concentration in the artery was the normalized iodine concentration (NIC), which was used with the aim of minimizing differences in patients, scanning times, and iodine concentrations. Slope of HU curve (λ HU ), which represented X-ray attenuation coefficient at different energy levels, was calculated using the following formula [ Li et al 2012 ; Wu et al 2014 ]:…”

Section: Methodsmentioning

confidence: 99%

“…However, MRI is time consuming and suffers from poor accessibility in some countries. However, CT features rapid screening and is widely available [ Wu et al 2014 ], though, also has its shortcomings. The averaging attenuation effect of polychromatic X-rays in conventional CT reduces the low-contrast spatial resolution between materials [ Lv et al 2011 ].…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of spectral computed tomography for evaluation of intestinal activity and severity in ileocolonic Crohn’s disease

Peng

Feng

Zhu

et al. 2016

Therap Adv Gastroenterol

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Background:Assessment of intestinal activity and severity of Crohn’s disease (CD) is crucial to guide treatment. In this study, we aimed to investigate the accuracy of spectral computed tomography (CT) in this assessment and make a comparison with conventional CT.Methods:A total of 50 patients with ileocolonic CD underwent spectral CT scanning. Conventional CT and spectral CT images were reconstructed. Endoscopic lesions were classified as absent, mild lesions and severe lesions. Qualitative and quantitative findings in CT images were compared in these segments. Logistic regressions were established, based on conventional and spectral CT parameters, to predict intestinal activity and severity. Comparisons were made by receiver operating characteristic (ROC) curve.Results:The results showed that bowel wall hyperenhancement, ulcers on CT images, comb sign, bowel wall thickness, normalized iodine concentration (NIC) and slope of HU curve (λHU) increased significantly (p < 0.01) with endoscopic severity. In predicting intestinal activity, spectral CT demonstrated higher accuracy (99.6% versus 94.7%), sensitivity (99.1% versus 93.4%) and specificity (99.9% versus 94.4%) than conventional CT. In predicting intestinal severity, spectral CT also had higher accuracy (96.5% versus 91.9%), sensitivity (96.5% versus 92.1%) and specificity (95.8% versus 89.8%) than conventional CT. Besides, both NIC and λHU correlated significantly with Simple Endoscopic Score for CD (r = 0.833 and r = 0.771; both p < 0.001), but their correlations with C-reactive protein (r = 0.578 and r = 0.513; both p < 0.01) and Harvey–Bradshaw Index (r = 0.545 and r = 0.522; both p < 0.01) were moderate.Conclusions:Compared with conventional CT, spectral CT had higher accuracy in detecting intestinal activity and severity of CD, which could be an alternative choice in evaluation of CD.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of spectral computed tomography for evaluation of intestinal activity and severity in ileocolonic Crohn’s disease

Peng

Feng

Zhu

et al. 2016

Therap Adv Gastroenterol

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“…Small prolactin-secreting adenomas in males may result in hypogonadotropic hypogonadism, with loss of libido and impotence [14]. Other common mass lesions that may affect the neuroendocrine system are germ-line tumors, meningioma, craniopharyngioma, and Rathke cleft cyst, among others [2,[15][16][17][18]. Metastatic lesions, sarcoid, and other inflammatory processes may involve the sella and parasellar regions as well.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

“…Intravenous (IV) contrast may be useful to characterize lesions or assess for soft-tissue invasion, but it should not be considered a first-line imaging test. CT using dual-energy techniques may discriminate larger pituitary masses from other lesions, such as meningioma [18]. Solid masses are more easily defined compared to cystic lesions, which may be confused with cerebral spinal fluid in the suprasellar cistern.…”

Section: Discussion Of Procedures By Variantmentioning

confidence: 99%

ACR Appropriateness Criteria® Neuroendocrine Imaging

Burns

Policeni

Bykowski

et al. 2019

Journal of the American College of Radiology

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Neuroendocrine dysfunction includes suspected hyper-and hypofunction of the pituitary gland. Causative lesions may include primary masses of the pituitary such as pituitary microadenomas and macroadenomas, as well as extrinsic masses, typically centered in the suprasellar cistern. Clinical syndromes related to hormonal dysfunction can be caused by excessive hormonal secretion or by inhibited secretion due to mass effect upon elements of the hypothalamic-pituitary axis. Additionally, complications such as hemorrhage may be seen in the setting of an underlying mass and can result in hormonal dysfunction. MRI with high-resolution protocols is the best firstline test to evaluate the sella turcica and parasellar region. CT provides complementary information regarding bony anatomy, and may be appropriate as a first-line test in certain instances, but it provides less detail and lesion characterization when compared to MRI.The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.Disclaimer: The ACR Committee on Appropriateness Criteria and its expert panels have developed criteria for determining appropriate imaging examinations for diagnosis and treatment of specified medical condition(s). These criteria are intended to guide radiologists, radiation oncologists, and referring physicians in making decisions regarding radiologic imaging and treatment. Generally, the complexity and severity of a patient's clinical condition should dictate the selection of appropriate imaging procedures or treatments. Only those examinations generally used for evaluation of the patient's condition are ranked. Other imaging studies necessary to evaluate other co-existent diseases or other medical consequences of this condition are not considered in this document. The availability of equipment or personnel may influence the selection of appropriate imaging procedures or treatments. Imaging techniques classified as investigational by the FDA have not been considered in developing these criteria; however, study of new equipment and applications should be encouraged. The ultimate decision regarding the appropriateness of any specific radiologic examination or treatment must be made by the referring physician and radiologist in light of all the circumstances presented in an individual examination.

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“…According to the concepts of modern molecular biology of tumors, the occurrence and development of tumors constitutes a multi-factorial, multi-step and complex biological evolutionary process involving the mutation of multiple genes, and pituitary adenoma is no exception (13)(14)(15). �TEN is among the tumor suppressor genes with the highest vulnerability to mutations (16,17).…”

Section: Discussionmentioning

confidence: 99%

Correlation of NEDD4-1 and PTEN expression with the invasive capacity of pituitary adenomas

Zhang

2016

Molecular and Clinical Oncology

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Abstract. The aim of the present study was to correlate the expression of neural precursor cell expressed developmentally downregulated 4-1 (NEDD4-1) and phosphatase and tensin homolog deleted on chromosome 10 (�TEN) with the inva-�TEN) with the invasive capacity of pituitary adenomas. A total of 50 pituitary adenoma tissues and 10 normal pituitary tissues were divided into the invasive group (26 cases), the non-invasive group (24 cases) and the normal group (10 cases). The expression of NEDD4-1 and �TEN was determined by immunohistochemistry. NEDD4-1 was revealed to be located in the nucleus and cytoplasm, whereas �TEN was only located in the cytoplasm. Furthermore, expression of NEDD4-1 was higher in pituitary adenomas compared with normal pituitary tissues (�<0.05), and higher in the invasive group compared with the non-invasive group, whereas the opposite trend was observed for �TEN. There was a strong negative correlation between NEDD4-1 and �TEN expression, indicating a dependency between the two and an association with invasiveness. In conclusion, NEDD4-1 may serve as a diagnostic and prognostic factor, and as a novel therapeutic target, in pituitary adenomas.

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Usefulness of Dual-Energy Computed Tomography Imaging in the Differential Diagnosis of Sellar Meningiomas and Pituitary Adenomas: Preliminary Report

Cited by 22 publications

References 8 publications

Usefulness of spectral computed tomography for evaluation of intestinal activity and severity in ileocolonic Crohn’s disease

Usefulness of spectral computed tomography for evaluation of intestinal activity and severity in ileocolonic Crohn’s disease

ACR Appropriateness Criteria® Neuroendocrine Imaging

Correlation of NEDD4-1 and PTEN expression with the invasive capacity of pituitary adenomas

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