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Predictive value of T2 relative signal intensity for response to somatostatin analogs in newly diagnosed acromegaly

  • Diagnostic Neuroradiology
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Abstract

Introduction

The difficulty of predicting the efficacy of somatostatin analogs (SSA) is not fully resolved. Here, we quantitatively evaluated the predictive value of relative signal intensity (rSI) on T1- and T2-weighted magnetic resonance imaging (MRI) for the short-term efficacy (3 months) of SSA therapy in patients with active acromegaly and assessed the correlation between MRI rSI and expression of somatostatin receptors (SSTR).

Methods

This was a retrospective review of prospectively recorded data. Ninety-two newly diagnosed patients (37 males and 55 females) with active acromegaly were recruited. All patients were treated with pre-surgical SSA, followed by reassessment and transspenoidal surgery. rSI values were generated by calculating the ratio of SI in the tumor to the SI of normal frontal white matter. The Youden indices were calculated to determine the optimal cutoff of rSI to determine the efficacy of SSA. The correlation between rSI and expression of SSTR2/5 was analyzed by the Spearman rank correlation coefficient.

Results

T2 rSI was strongly correlated with biochemical sensitivity to SSA. The cutoff value of T2 rSI to distinguish biochemical sensitivity was 1.205, with a positive predictive value (PPV) of 81.5 % and a negative predictive value (NPV) of 77.3 %. No correlation was found between MRI and tumor size sensitivity. Moreover, T2 rSI was negatively correlated with the expression of SSTR5.

Conclusion

T2 rSI correlates with the expression of SSTR5 and quantitatively predicts the biochemical efficacy of SSA in acromegaly.

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Acknowledgments

This study was supported by grants from the National High Technology Research and Development Program of China (No. 2014AA02061), the National Program for Support of Top-Notch Young Professionals, the National Natural Science Foundation of China (No. 81172391, No. 81370938, No. 81370884), the Program for New Century Excellent Talents in University (NCET-10-0356), the Shanghai Rising-Star Tracking Program (12QH1400400), the China Pituitary Adenoma Specialist Council (CPASC), the Shanghai Science and Technology Committee (11PJ1402000) and the Shanghai Municipal Commission of Health and Family Planning (XYQ2011002, XYQ2013120).

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    Authors and Affiliations

    1. Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, 12 Wulumuqi Zhong Road, Shanghai, 200040, China

      Ming Shen, Qilin Zhang, Zengyi Ma, Wenqiang He, Shiqi Li, Xuefei Shou, Nidan Qiao, Zhao Ye, Yichao Zhang, Yao Zhao & Yongfei Wang

    2. Shanghai Pituitary Tumor Center, Shanghai, China

      Ming Shen, Qilin Zhang, Wenjuan Liu, Jingjing Zhu, Zengyi Ma, Wenqiang He, Shiqi Li, Xuefei Shou, Yiming Li, Zhaoyun Zhang, Hongying Ye, Min He, Bin Lu, Zhenwei Yao, Nidan Qiao, Zhao Ye, Yichao Zhang, Yeping Yang, Yao Zhao & Yongfei Wang

    3. Department of Endocrinology and Metabolism, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

      Wenjuan Liu, Meng Wang, Yiming Li, Zhaoyun Zhang, Hongying Ye, Min He, Bin Lu & Yeping Yang

    4. Division of Endocrinology, the Second Affiliated Hospital, Soochow University, Suzhou, China

      Meng Wang

    5. Department of Neuropathology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

      Jingjing Zhu

    6. Department of Radiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

      Zhenwei Yao

    7. Department of Nuclear Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China

      Yun Lu

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    1. Ming Shen
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    Correspondence to Yao Zhao or Yongfei Wang.

    Ethics declarations

    We declare that all human and animal studies have been approved by the ethics committee at Huashan Hospital and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

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    We declare that we have no conflict of interest.

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    MS and QZ contributed equally to this work.

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    Shen, M., Zhang, Q., Liu, W. et al. Predictive value of T2 relative signal intensity for response to somatostatin analogs in newly diagnosed acromegaly. Neuroradiology 58, 1057–1065 (2016). https://doi.org/10.1007/s00234-016-1728-4

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