Article: Is systematic Gadolinium injection relevant during MRI follow-up for non-functioning pituitary macroadenomas?
Journal of neuroradiology = Journal de neuroradiologie
2022 Volume 50, Issue 1, Page(s) 3–8
Abstract: Objective: To compare the performance of coronal contrast-enhanced T1-weighted (ceT1-w) and T2-weighted (T2-w) sequences for diagnosing progression during the MRI follow-up of Non-Functioning Pituitary MacroAdenomas (NFPMAs).: Patients and methods: ... ...
Abstract | Objective: To compare the performance of coronal contrast-enhanced T1-weighted (ceT1-w) and T2-weighted (T2-w) sequences for diagnosing progression during the MRI follow-up of Non-Functioning Pituitary MacroAdenomas (NFPMAs). Patients and methods: 106 patients, who had at least two MRIs for the follow-up of NFPMA, were enrolled retrospectively. The largest adenoma diameter was measured on coronal ceT1-w sequences and separately on T2-w sequences for all follow-up MRIs. Interobserver variability was also assessed by 2 independent neuroradiologists in a sample series of 100 examinations. Progression was defined by an increase ≥ 2 mm in diameter between 2 MRIs. Progression thresholds of 3 and 4 mm were also tested. The results of ceT1-w and T2-w sequences were analysed for concordance. Results: 93.1% concordance was achieved between ceT1-w and T2-w coronal sequences in 580 follow-up MRIs. In the case of progression detected on at least one sequence, 64.4% concordance was documented for a 2-mm threshold, 87.7% for 3-mm and 97.1% for 4-mm. Discordance was mainly observed on the first postoperative MRI and in case of NFPMAs with multiple recurrences. Kappa was better for diagnosing progression on T2-w than on ceT1-w sequences (0.67 vs. 0.54). It should be noted that 100% agreement was observed between the 2 sequences in the 82 follow-up MRIs of patients with complete surgical resection. Conclusion: 93.1% concordance was achieved for coronal ceT1-w and T2-w sequences during the MRI follow-up of NFPMAs, thus challenging systematic injection of gadolinium. If MRI without gadolinium injection is a first-line option, our results suggest that ceT1-w sequences should be reserved for the first postoperative MRI and for the follow-up of aggressive and recurrent NFPMAs. |
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MeSH term(s) | Humans ; Gadolinium ; Follow-Up Studies ; Retrospective Studies ; Magnetic Resonance Imaging/methods ; Observer Variation ; Contrast Media ; Pituitary Neoplasms/diagnostic imaging ; Pituitary Neoplasms/surgery |
Chemical Substances | Gadolinium (AU0V1LM3JT) ; Contrast Media |
Language | English |
Publishing date | 2022-08-30 |
Publishing country | France |
Document type | Journal Article |
ZDB-ID | 131763-5 |
ISSN | 1773-0406 ; 0150-9861 |
ISSN (online) | 1773-0406 |
ISSN | 0150-9861 |
DOI | 10.1016/j.neurad.2022.08.003 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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