Department of Diagnostic and Interventional Radiology, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
Department of Diagnostic Radiology, Toranomon Hospital, Minato-ku, Tokyo, Japan.
Jpn J Radiol. 2023 Sep;41(9):938-946. doi: 10.1007/s11604-023-01420-3. Epub 2023 Apr 7.
Silent corticotroph pituitary adenomas (SCAs)/pituitary neuroendocrine tumors (PitNETs) are common non-functioning pituitary adenomas (NFAs)/PitNETs with a clinically aggressive course. This study aimed to investigate the ability of time-intensity analysis of dynamic magnetic resonance imaging (MRI) for distinguishing adrenocorticotropic hormone (ACTH)-positive SCAs and ACTH-negative SCAs from other NFAs.
We retrospectively evaluated the dynamic MRI findings of patients with NFAs. The initial slope of the kinetic curve (slope) obtained by dynamic MRI for each tumor was analyzed using a modified empirical mathematical model. The maximum slope of the kinetic curve (slope) was obtained by geometric calculation.
A total of 106 patients with NFAs (11 ACTH-positive SCAs, 5 ACTH-negative SCAs, and 90 other NFAs) were evaluated. The kinetic curves of ACTH-positive SCAs had significantly lesser slope and slope compared with ACTH-negative SCAs (P = 0.040 and P = 0.001, respectively) and other NFAs (P = 0.018 and P = 0.035, respectively). Conversely, the slope and slope were significantly greater in ACTH-negative SCAs than in NFAs other than ACTH-negative SCAs (P = 0.033 and P = 0.044, respectively). In receiver operating characteristic analysis of ACTH-positive SCAs and other NFAs, the area under the curve (AUC) values for slope and slope were 0.762 and 0748, respectively. In predicting ACTH-negative SCAs, the AUC values for slope and slope were 0.784 and 0.846, respectively.
Dynamic MRI can distinguish ACTH-positive SCAs and ACTH-negative SCAs from other NFAs.
无声促肾上腺皮质激素垂体腺瘤（SCAs）/垂体神经内分泌肿瘤（PitNETs）是常见的无功能垂体腺瘤（NFAs）/PitNETs，具有侵袭性的临床病程。本研究旨在探讨动态磁共振成像（MRI）时间强度分析区分促肾上腺皮质激素（ACTH）阳性 SCA 和 ACTH 阴性 SCA 与其他 NFAs 的能力。
我们回顾性评估了 NFAs 患者的动态 MRI 发现。使用改良的经验数学模型分析动态 MRI 获得的每个肿瘤的动力学曲线初始斜率（斜率）。通过几何计算获得动力学曲线的最大斜率（斜率）。
共评估了 106 例 NFAs 患者（11 例 ACTH 阳性 SCA、5 例 ACTH 阴性 SCA 和 90 例其他 NFAs）。ACTH 阳性 SCA 的动力学曲线斜率和斜率明显小于 ACTH 阴性 SCA（P=0.040 和 P=0.001）和其他 NFAs（P=0.018 和 P=0.035）。相反，ACTH 阴性 SCA 的斜率和斜率明显大于除 ACTH 阴性 SCA 以外的 NFAs（P=0.033 和 P=0.044）。在预测 ACTH 阳性 SCA 和其他 NFAs 的受试者工作特征分析中，斜率和斜率的曲线下面积（AUC）值分别为 0.762 和 0.748。在预测 ACTH 阴性 SCA 时，斜率和斜率的 AUC 值分别为 0.784 和 0.846。
动态 MRI 可以区分 ACTH 阳性 SCA 和 ACTH 阴性 SCA 与其他 NFAs。
