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Quantitative pharmacokinetic analysis of high-temporal-resolution dynamic contrast-enhanced MRI to differentiate the normal-appearing pituitary gland from pituitary macroadenoma

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Abstract

Purpose

To evaluate the usefulness of high-temporal-resolution dynamic contrast-enhanced (DCE) MRI and quantitative pharmacokinetic analysis to differentiate the normal-appearing pituitary gland from a pituitary macroadenoma.

Materials and methods

Twenty-seven patients with macroadenomas underwent preoperative DCE-MRI with a temporal resolution of 5 s using compressed sensing to obtain pharmacokinetic parameters. Two independent observers localized the normal-appearing pituitary gland on post-contrast T1-weighted images before and after referring to the corresponding Ktrans maps. Agreements between the localizations and intraoperative findings were evaluated using the kappa statistics. The Mann–Whitney U test was used to compare the pharmacokinetic parameters of the normal-appearing pituitary gland and adenoma.

Results

For both observers, the agreement between the MRI-based localization and the intraoperative findings increased after referring to the Ktrans maps (observer 1, 0.930–1; observer 2, 0.636–0.855). The normal-appearing pituitary gland had significantly higher Ktrans [/min] (1.50 ± 0.80 vs 0.58 ± 0.49, P < 0.0001), kep [/min] (3.19 ± 1.29 vs 2.15 ± 1.18, P = 0.0049), and ve (0.43 ± 0.15 vs 0.25 ± 0.17, P = 0.0003) than adenoma.

Conclusion

High-temporal-resolution DCE-MRI and quantitative pharmacokinetic analysis help accurately localize the normal-appearing pituitary gland in patients with macroadenomas. The normal-appearing pituitary gland was characterized by higher Ktrans, kep, and ve than macroadenoma.

Condensed abstract

Dynamic contrast-enhanced MRI with high-temporal-resolution using compressed sensing was used for quantitative pharmacokinetic analysis of pituitary macroadenomas. An observer study, the use of Ktrans maps improved accuracy in localizing the normal-appearing pituitary gland. As compared to an adenoma, the normal-appearing pituitary gland had significantly higher Ktrans, kep, and ve values.

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Acknowledgements

This paper was presented at the 78th annual meeting of the Japan Radiological Society (JRS) in Yokohama, Japan, in 2019. The authors wish to thank the staff of Kagoshima University Hospital for their support. The authors would like to thank Enago (www.enago.jp) for the English language review.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan

    Kiyohisa Kamimura, Masanori Nakajo, Tomohide Yoneyama, Manisha Bohara, Ryota Nakanosono, Yoshihiko Fukukura & Takashi Yoshiura

  2. Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

    Shingo Fujio

  3. Clinical Engineering Department Radiation Section, Kagoshima University Hospital, Kagoshima, Japan

    Takashi Iwanaga

  4. Siemens Healthcare, Erlangen, Germany

    Marcel Dominik Nickel

  5. Siemens Healthcare K.K., Tokyo, Japan

    Hiroshi Imai

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  1. Kiyohisa Kamimura
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Correspondence to Kiyohisa Kamimura.

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Written informed consent was waived by the Institutional Review Board.

Ethical statement

The study protocol was approved by the Ethics Committee of Kagoshima University Graduate School of Medical and Dental Sciences (approval no. 180255) and was conducted in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Kamimura, K., Nakajo, M., Yoneyama, T. et al. Quantitative pharmacokinetic analysis of high-temporal-resolution dynamic contrast-enhanced MRI to differentiate the normal-appearing pituitary gland from pituitary macroadenoma . Jpn J Radiol 38, 649–657 (2020). https://doi.org/10.1007/s11604-020-00942-4

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