The utility of dynamic MRI in differentiating the hormone-producing ability of pituitary adenomas

Jpn J Radiol. 2021 Aug;39(8):741-748. doi: 10.1007/s11604-021-01121-9. Epub 2021 Apr 21.

Abstract

Purpose: To investigate the relationship between dynamic magnetic resonance imaging (MRI) findings and hormonal activity in pituitary adenomas.

Methods: We retrospectively evaluated the dynamic MRI findings in 244 patients with pathologically confirmed pituitary adenomas and a diagnosis of clinically active prolactin (PRL)-producing adenomas. Among the 244 pituitary adenomas, 55, 16, 6, and 4 produced growth hormone (GH), PRL, adrenocorticotropic hormone, and thyroid-stimulating hormone, respectively, while 163 were non-functioning (NF) adenomas. For each adenoma, we calculated the washout rate (WR) and early (EER) and delayed (DER) tumour-to-normal-tissue enhancement ratios.

Results: The respective mean values of the WR, EER, and DER were 9.4%, 75.2%, and 64.5% for GH-producing adenomas; 6.2%, 117.1%, and 106.2% for PRL-producing adenomas; and 5.4%, 116.7%, and 108.7% for NF adenomas. GH-producing adenomas had significantly lower EER and DER values than PRL-producing (P < 0.001) and NF adenomas (P < 0.001). In ROC analysis of GH-producing and non-GH-producing adenomas, the areas under the curves of WR, EER, and DER were 0.593, 0.825, and 0.857, respectively.

Conclusion: There are differences in dynamic MRI features between GH-producing and non-GH-producing adenomas, which suggests that EER and DER may be useful for diagnosing GH-producing adenomas.

Keywords: Dynamic contrast enhancement; Magnetic resonance imaging; Pituitary adenoma; Pituitary hormonal activity.

MeSH terms

  • Adenoma* / diagnostic imaging
  • Adult
  • Aged
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Pituitary Neoplasms* / diagnostic imaging
  • Prolactin
  • Retrospective Studies

Substances

  • Prolactin