title: Magnetic resonance imaging and histology correlation in Cushing's disease.
abstract: BACKGROUND
  We continuously look for new techniques to improve the radicality of resection and to eliminate the negative effects of surgery. One of the methods that has been implemented in the perioperative management of Cushing's disease was the combination of three magnetic resonance imaging (MRI) sequences: SE, SPGR and fSPGR.
  
  
  METHODS
  We enrolled 41 patients (11 males, 30 females) diagnosed with Cushing's disease. A 3D tumour model with a navigation console was developed using each SPGR, fSPGR and SE sequence. The largest model was then used. In all cases, a standard four-handed, bi-nostril endoscopic endonasal technique was used. Endocrinological follow-up evaluation using morning cortisol sampling was performed for 6-34 months in our study.
  
  
  RESULTS
  In total, 36 patients (88%) were disease-free following surgery. Our results indicate we achieved 100% sensitivity of MR. Overall, the conformity of at least one donor site, as compared with the places designated on MR, was in 78% of patients. We searched the place of compliance in individual locations. There is a consensus in individual locations in 63 of the 123 cases (or 56%). The correlation gamma function at a 5% significance level was then 0.27.
  
  
  CONCLUSIONS
  The combination of MR sequences (SE, SPGR, fSPGR), neuronavigation system and iMRI led to increased sensitivity of up to 100%. Specificity reached 56% in our study.
  
  
  CONCLUSIONS
  We found a high success rate in surgical procedure in terms of the correlation between MR findings and histology, which leads to remission of Cushing's disease.
authors.affiliation: Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czechia. Electronic address: masopust@uvn.cz.
authors.forename: Václav
authors.initials: V
authors.lastname: Masopust
authors.affiliation: Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czechia.
authors.forename: David
authors.initials: D
authors.lastname: Netuka
authors.affiliation: Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czechia.
authors.forename: Vladimír
authors.initials: V
authors.lastname: Beneš
authors.affiliation: Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czechia.
authors.forename: Martin
authors.initials: M
authors.lastname: Májovský
authors.affiliation: Department of Radiology, Central Military Hospital, Prague, Czechia.
authors.forename: Tomáš
authors.initials: T
authors.lastname: Belšán
authors.affiliation: Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague, Czechia.
authors.forename: Ondřej
authors.initials: O
authors.lastname: Bradáč
authors.affiliation: Department of Neurosurgery, Faculty Hospital, Ústí nad Labem, Czechia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Hořínek
authors.affiliation: 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Prague, Czechia.
authors.forename: Mikuláš
authors.initials: M
authors.lastname: Kosák
authors.affiliation: 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Prague, Czechia.
authors.forename: Václav
authors.initials: V
authors.lastname: Hána
authors.affiliation: 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Prague, Czechia.
authors.forename: Michal
authors.initials: M
authors.lastname: Kršek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D038361:Neuronavigation / Q000379:methods*; D047748:Pituitary ACTH Hypersecretion / Q000000981:diagnostic imaging* / Q000601:surgery*; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: Endoscopic resection; Magnetic resonance imaging; Pituitary adenoma