title: Dynamic intraoperative MRI in transsphenoidal resection of pituitary macroadenomas: a quantitative analysis.
abstract: OBJECTIVE
  To compare intraoperative dynamic contrast-enhanced (dCE) sequences with conventional CE (cCE) in the evaluation of the surgical bed after transsphenoidal removal of pituitary macroadenomas.
  
  
  METHODS
  Twenty-one patients with macroadenoma were selected. They all underwent intraoperative magnetic resonance imaging (iMRI) (1.5T) acquisitions during transsphenoidal resection of the tumor. For each patient, dCE and cCE images were acquired in the operating room after tumor removal. The mean values of surgical cavities volumes were measured and statistically compared through Student's t-test analysis. Informed consent to iMRI was obtained from the patients as a part of the surgical procedure. Institutional Review Board (IRB) approval was obtained.
  
  
  RESULTS
  No patient showed recurrence within at least 1 year of follow-up. Two patients showed residual tumor in the iMRI. Intraoperative analysis of the remaining 19 demonstrated that the mean value of the surgical cavities was significantly bigger in dCE than in cCE images (2955 mm(3) vs. 1963 mm(3) , respectively, P = 0.022).
  
  
  CONCLUSIONS
  This study demonstrated underestimation of surgical cavity by conventional iMRI, simulating residual tumor and potentially leading to unnecessary surgical revision.
authors.affiliation: Neuroradiology NESMOS Department, University of Rome "La Sapienza" and Azienda Ospedaliera Sant'Andrea, Rome.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Boellis
authors.forename: Maria Camilla Rossi
authors.initials: MC
authors.lastname: Espagnet
authors.forename: Andrea
authors.initials: A
authors.lastname: Romano
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trillò
authors.forename: Antonino
authors.initials: A
authors.lastname: Raco
authors.forename: Marta
authors.initials: M
authors.lastname: Moraschi
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bozzao
mesh_terms: D000236:Adenoma / Q000473:pathology* / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000175:diagnosis; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery*
keywords: dynamic iMRI; intraoperative MRI; pituitary macroadenoma; transsphenoidal surgery