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

Kiyohisa Kamimura; Masanori Nakajo; Tomohide Yoneyama; Manisha Bohara; Ryota Nakanosono; Shingo Fujio; Takashi Iwanaga; Marcel Dominik Nickel; Hiroshi Imai; Yoshihiko Fukukura; Takashi Yoshiura

doi:10.1007/s11604-020-00942-4

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

Jpn J Radiol. 2020 Jul;38(7):649-657. doi: 10.1007/s11604-020-00942-4. Epub 2020 Mar 11.

Affiliations

¹ Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan. kiyohisa@m2.kufm.kagoshima-u.ac.jp.
² Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
³ Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
⁴ Clinical Engineering Department Radiation Section, Kagoshima University Hospital, Kagoshima, Japan.
⁵ Siemens Healthcare, Erlangen, Germany.
⁶ Siemens Healthcare K.K., Tokyo, Japan.

PMID: 32162178
DOI: 10.1007/s11604-020-00942-4

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 K^trans 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 K^trans maps (observer 1, 0.930-1; observer 2, 0.636-0.855). The normal-appearing pituitary gland had significantly higher K^trans [/min] (1.50 ± 0.80 vs 0.58 ± 0.49, P < 0.0001), k_ep [/min] (3.19 ± 1.29 vs 2.15 ± 1.18, P = 0.0049), and v_e (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 K^trans, k_ep, and v_e than macroadenoma. 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 K^trans maps improved accuracy in localizing the normal-appearing pituitary gland. As compared to an adenoma, the normal-appearing pituitary gland had significantly higher K^trans, k_ep, and v_e values.

Keywords: Dynamic contrast-enhanced magnetic resonance imaging; Pharmacokinetic analysis; Pituitary adenoma; Pituitary gland.

Publication types

Evaluation Study

MeSH terms

Adenoma / diagnostic imaging*
Adult
Aged
Aged, 80 and over
Contrast Media / pharmacokinetics*
Diagnosis, Differential
Evaluation Studies as Topic
Female
Humans
Image Enhancement / methods*
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Pituitary Gland / diagnostic imaging
Pituitary Neoplasms / diagnostic imaging*
Reproducibility of Results
Retrospective Studies

Substances

Contrast Media