Virtual magnetic resonance elastography has the feasibility to evaluate preoperative pituitary adenoma consistency

Purpose To evaluate the use of preoperative virtual Magnetic Resonance Elastography (vMRE) for patients undergoing transsphenoidal resection of pituitary adenomas (PA). Methods Ten patients (60.2 ± 19.6 years; 8 males) were prospectively examined with the vMRE-method prior to transsphenoidal surgery...

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Bibliographic Details
Published in:	Pituitary Vol. 24; no. 4; pp. 530 - 541
Main Authors:	Lagerstrand, Kerstin, Gaedes, Nicholas, Eriksson, Stig, Farahmand, Dan, De Coursey, Erica, Johansson, Gudmundur, Jönsson, Lars, Skoglund, Thomas
Format:	Journal Article
Language:	English
Published:	New York Springer US 01-08-2021 Springer Nature B.V
Subjects:	Adenoma Endocrinology Endocrinology and Diabetes Endokrinologi och diabetes Human Physiology Kirurgi Medicine Medicine & Public Health Neurologi Neurology Patients Pituitary Radiologi och bildbehandling Radiology, Nuclear Medicine and Medical Imaging Surgery Tumors Virtual elastography Pituitary macroadenoma Stiffness Magnetic resonance imaging Consistency
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Summary:	Purpose To evaluate the use of preoperative virtual Magnetic Resonance Elastography (vMRE) for patients undergoing transsphenoidal resection of pituitary adenomas (PA). Methods Ten patients (60.2 ± 19.6 years; 8 males) were prospectively examined with the vMRE-method prior to transsphenoidal surgery. vMRE-images, reflecting tissue stiffness were reconstructed. From these images, histograms as well as the mean stiffness values over the tumor body were extracted. Finally, vMRE-data was compared with the PA consistency at surgery blinded to vMRE. Results In all patients, successful vMRE-examination was performed enabling evaluation of even small PAs. For tumors with homogenous tissue, the mean stiffness value increased with surgical consistency grading. For heterogenous tumors, however, the mean stiffness value did not consistently reflect the grading at surgery. On the other hand, the vMRE-images and histograms were found to be able to characterize the tumor heterogeneity and display focal regions of high stiffness that were found to affect the surgery outcome in these PAs. The vMRE-images and histograms showed great promise in characterizing the consistency at surgery for these PAs. Conclusion Evaluation of PA consistency in preparation for surgery seems to be feasible using the vMRE-method. Our findings also address the need for high resolution diagnostic methods that can non-invasively display focal regions of increased stiffness, as such regions may increase the difficulty of transsphenoidal PA-resection.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1386-341X 1573-7403 1573-7403
DOI:	10.1007/s11102-021-01129-4