Kamimura Kiyohisa, Tokuda Tomohiro, Kamizono Junki, Nakano Tsubasa, Hasegawa Tomohito, Nakajo Masanori, Ejima Fumitaka, Kanzaki Fumiko, Takumi Koji, Nakajo Masatoyo, Fujio Shingo, Hanaya Ryosuke, Tanimoto Akihide, Iwanaga Takashi, Imai Hiroshi, Feiweier Thorsten, Yoshiura Takashi
Department of Advanced Radiological Imaging, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
J Neuroimaging. 2025 Jan-Feb;35(1):e13254. doi: 10.1111/jon.13254.
Differentiation between functioning and nonfunctioning pituitary adenomas/pituitary neuroendocrine tumors (PAs) is clinically relevant. The goal of this study was to determine the feasibility of using time-dependent diffusion MRI (dMRI) for microstructural characterization of PAs.
The study included 54 participants, 24 with functioning PA and 30 with nonfunctioning PA. Time-dependent dMRI of the pituitary gland was performed using an inner field-of-view echo-planar imaging based on 2-dimensional-selective radiofrequency excitations with oscillating gradient and pulsed gradient preparation (effective diffusion time: 7.1 and 36.3 ms) at b-values of 0 and 1000 seconds/mm. Each tumor had its apparent diffusion coefficients (ADCs) measured at two diffusion times (ADC and ADC), its ADC change (cADC), and relative ADC change. The mean values of diffusion parameters were compared between functioning and nonfunctioning PAs. We compared the diffusion parameters of nonfunctioning PAs with those of each type of hormone-producing PAs. The diagnostic performances of the diffusion parameters were assessed.
The cADC was significantly higher in functioning PAs than nonfunctioning PAs (p = .0124). The receiver operating characteristic (ROC) curve analysis revealed that cADC (area under the ROC curve [AUC] = .677, p = .017) is effective in distinguishing between functioning and nonfunctioning PAs. The cADC was significantly higher in growth hormone (GH)-producing PAs compared to nonfunctioning PAs (p = .006). The ROC curve analysis indicated that cADC (AUC = .771, p < .001) effectively distinguishes between GH-producing and nonfunctioning PAs.
The cADC derived from time-dependent dMRI could distinguish between functioning and nonfunctioning PAs, particularly those producing GH.
区分功能性与非功能性垂体腺瘤/垂体神经内分泌肿瘤（PAs）具有临床意义。本研究的目的是确定使用时间依赖扩散磁共振成像（dMRI）对PAs进行微观结构特征分析的可行性。
该研究纳入54名参与者，其中24名患有功能性PA，30名患有非功能性PA。采用基于二维选择性射频激发、振荡梯度和脉冲梯度准备的内视野回波平面成像（有效扩散时间：7.1和36.3毫秒），在b值为0和1000秒/毫米时对垂体进行时间依赖dMRI检查。每个肿瘤在两个扩散时间测量其表观扩散系数（ADC）（ADC和ADC）、ADC变化（cADC）以及相对ADC变化。比较功能性和非功能性PAs之间扩散参数的平均值。我们将非功能性PAs的扩散参数与每种产生激素的PAs的扩散参数进行比较。评估扩散参数的诊断性能。
功能性PAs的cADC显著高于非功能性PAs（p = 0.0124）。受试者工作特征（ROC）曲线分析显示，cADC（ROC曲线下面积[AUC]=0.677，p = 0.017）在区分功能性和非功能性PAs方面有效。与非功能性PAs相比，生长激素（GH）分泌型PAs的cADC显著更高（p = 0.006）。ROC曲线分析表明，cADC（AUC = 0.771，p < 0.001）能有效区分GH分泌型和非功能性PAs。
从时间依赖dMRI得出的cADC能够区分功能性和非功能性PAs，尤其是那些分泌GH的PAs。
