title: Predictive role of dynamic contrast enhanced T1-weighted MR sequences in pre-surgical evaluation of macroadenomas consistency.
abstract: OBJECTIVE
  Our hypothesis was that pituitary macroadenomas show different areas of consistency detectable by enhanced magnetic resonance imaging (MRI) with Dynamic study during gadolinium administration.
  
  
  METHODS
  We analysed 21 patients with pituitary macroadenomas between June 2013 and June 2015. All patients underwent trans-sphenoidal surgery and neurosurgeon described macroadenomas consistency. Similarly, two neuroradiologists manually drew regions of interest (ROIs) inside the solid-appearing portions of macroadenoma and in the normal white matter both on dynamic and post-contrast acquisitions. The ratio between these ROIs, defined as Signal Intensity Ratio (SIR), allowed obtaining signal intensity curves over time on dynamic acquisition and a single value on post-contrast MRI. SIR values best differentiating solid from soft macroadenoma components were calculated and correlated with pathologic patterns. A two-sample T test and empiric receiver operating characteristic (ROC) curve of SIR was performed.
  
  
  RESULTS
  According to ROC analysis, the SIR value of 1.92, obtained by dynamic acquisition, best distinguished soft and hard components. All the specimens from soft components were characterized by high cellularity, high representation of vascularization and micro-haemorrhage and low percentage of collagen content. The reverse was evident in hard components.
  
  
  CONCLUSIONS
  We demonstrated that dynamic MRI acquisition could distinguish with good accuracy macroadenomas consistency.
authors.affiliation: Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy. andrea.romano@uniroma1.it.|Department of Odontostomatological and Maxillo-Facial Sciences, Umberto I Hospital, University Sapienza, Rome, Italy. andrea.romano@uniroma1.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Romano
authors.affiliation: Department of Neuroradiology, S. Carlo Hospital, Potenza, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Coppola
authors.affiliation: Department of Histopathology, S. Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Mariangela
authors.initials: M
authors.lastname: Lombardi
authors.affiliation: Department of Neurosurgery, S. Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Lavorato
authors.affiliation: Department of Histopathology, S. Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Domenica
authors.initials: D
authors.lastname: Di Stefano
authors.affiliation: Department of Neurosurgery, S. Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Emanuela
authors.initials: E
authors.lastname: Caroli
authors.affiliation: Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy.|Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, Rome, Italy.
authors.forename: Maria Camilla
authors.initials: MC
authors.lastname: Rossi Espagnet
authors.affiliation: Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Tavanti
authors.affiliation: Department of Radiotherapy, S. Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Minniti
authors.affiliation: Department of Neurosurgery, S. Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Trillò
authors.affiliation: Department of Neuroradiology, S. Andrea Hospital, University Sapienza, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Bozzao
mesh_terms: D000328:Adult; D000368:Aged; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000175:diagnosis* / Q000601:surgery; D012372:ROC Curve
chemical_list: D003287:Contrast Media
keywords: Dynamic contrast-enhanced; MRI; Pituitary macroadenoma; Time-intensity curves; Tumoral consistency