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High resolution pituitary gland MRI at 7.0 tesla: a clinical evaluation in Cushing's disease.

de Rotte AA, Groenewegen A, Rutgers DR, Witkamp T, Zelissen PM, Meijer FJ, van Lindert EJ, Hermus A, Luijten PR, Hendrikse J - Eur Radiol (2015)

Bottom Line: A comparison was made between the lesions visualized with MRI and the lesions found during surgery in 9/16 patients.In three patients, 7.0 T MRI detected a lesion on the correct side of the pituitary gland, while no lesion was visible at 1.5 T MRI.Interobserver agreement for lesion detection on 1.5 T MRI was good; Interobserver agreement for lesion detection on 7.0 T MRI was good; 7.0 T enabled confirmation of unclear lesions at 1.5 T; 7.0 T enabled visualization of lesions not visible at 1.5 T.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, Postbox 85500, 3508 GA, Utrecht, The Netherlands. A.A.J.deRotte@umcutrecht.nl.

ABSTRACT

Objective: To evaluate the detection of pituitary lesions at 7.0 T compared to 1.5 T MRI in 16 patients with clinically and biochemically proven Cushing's disease.

Methods: In seven patients, no lesion was detected on the initial 1.5 T MRI, and in nine patients it was uncertain whether there was a lesion. Firstly, two readers assessed both 1.5 T and 7.0 T MRI examinations unpaired in a random order for the presence of lesions. Consensus reading with a third neuroradiologist was used to define final lesions in all MRIs. Secondly, surgical outcome was evaluated. A comparison was made between the lesions visualized with MRI and the lesions found during surgery in 9/16 patients.

Results: The interobserver agreement for lesion detection was good at 1.5 T MRI (κ = 0.69) and 7.0 T MRI (κ = 0.62). In five patients, both the 1.5 T and 7.0 T MRI enabled visualization of a lesion on the correct side of the pituitary gland. In three patients, 7.0 T MRI detected a lesion on the correct side of the pituitary gland, while no lesion was visible at 1.5 T MRI.

Conclusion: The interobserver agreement of image assessment for 7.0 T MRI in patients with Cushing's disease was good, and lesions were detected more accurately with 7.0 T MRI.

Key points: Interobserver agreement for lesion detection on 1.5 T MRI was good; Interobserver agreement for lesion detection on 7.0 T MRI was good; 7.0 T enabled confirmation of unclear lesions at 1.5 T; 7.0 T enabled visualization of lesions not visible at 1.5 T.

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The 1.5 T and 7.0 T MR images of a 56-year-old woman with Cushing’s disease. The lesion marked in the 1.5 T images (white arrowhead) was identified by only one of the two observers. Note that this lesion was only visible on one slice. After consensus with a third observer, the final decision was “no lesions”. The lesion marked in the 7.0 T images (white arrow) was identified by both observers
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Fig1: The 1.5 T and 7.0 T MR images of a 56-year-old woman with Cushing’s disease. The lesion marked in the 1.5 T images (white arrowhead) was identified by only one of the two observers. Note that this lesion was only visible on one slice. After consensus with a third observer, the final decision was “no lesions”. The lesion marked in the 7.0 T images (white arrow) was identified by both observers

Mentions: Examples are given in Figs. 1 and 2. In the patient in Fig. 1, initially no pathologies were identified on 1.5 T MRI. For the current study, there was discrepancy between both observers for the 1.5 T MRI, only one observer identified a lesion. On 7.0 T, however, both observers identified this lesion. This case demonstrates that 7.0 T MRI might contribute to a more certain diagnosis.Fig. 1


High resolution pituitary gland MRI at 7.0 tesla: a clinical evaluation in Cushing's disease.

de Rotte AA, Groenewegen A, Rutgers DR, Witkamp T, Zelissen PM, Meijer FJ, van Lindert EJ, Hermus A, Luijten PR, Hendrikse J - Eur Radiol (2015)

The 1.5 T and 7.0 T MR images of a 56-year-old woman with Cushing’s disease. The lesion marked in the 1.5 T images (white arrowhead) was identified by only one of the two observers. Note that this lesion was only visible on one slice. After consensus with a third observer, the final decision was “no lesions”. The lesion marked in the 7.0 T images (white arrow) was identified by both observers
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4666272&req=5

Fig1: The 1.5 T and 7.0 T MR images of a 56-year-old woman with Cushing’s disease. The lesion marked in the 1.5 T images (white arrowhead) was identified by only one of the two observers. Note that this lesion was only visible on one slice. After consensus with a third observer, the final decision was “no lesions”. The lesion marked in the 7.0 T images (white arrow) was identified by both observers
Mentions: Examples are given in Figs. 1 and 2. In the patient in Fig. 1, initially no pathologies were identified on 1.5 T MRI. For the current study, there was discrepancy between both observers for the 1.5 T MRI, only one observer identified a lesion. On 7.0 T, however, both observers identified this lesion. This case demonstrates that 7.0 T MRI might contribute to a more certain diagnosis.Fig. 1

Bottom Line: A comparison was made between the lesions visualized with MRI and the lesions found during surgery in 9/16 patients.In three patients, 7.0 T MRI detected a lesion on the correct side of the pituitary gland, while no lesion was visible at 1.5 T MRI.Interobserver agreement for lesion detection on 1.5 T MRI was good; Interobserver agreement for lesion detection on 7.0 T MRI was good; 7.0 T enabled confirmation of unclear lesions at 1.5 T; 7.0 T enabled visualization of lesions not visible at 1.5 T.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, Postbox 85500, 3508 GA, Utrecht, The Netherlands. A.A.J.deRotte@umcutrecht.nl.

ABSTRACT

Objective: To evaluate the detection of pituitary lesions at 7.0 T compared to 1.5 T MRI in 16 patients with clinically and biochemically proven Cushing's disease.

Methods: In seven patients, no lesion was detected on the initial 1.5 T MRI, and in nine patients it was uncertain whether there was a lesion. Firstly, two readers assessed both 1.5 T and 7.0 T MRI examinations unpaired in a random order for the presence of lesions. Consensus reading with a third neuroradiologist was used to define final lesions in all MRIs. Secondly, surgical outcome was evaluated. A comparison was made between the lesions visualized with MRI and the lesions found during surgery in 9/16 patients.

Results: The interobserver agreement for lesion detection was good at 1.5 T MRI (κ = 0.69) and 7.0 T MRI (κ = 0.62). In five patients, both the 1.5 T and 7.0 T MRI enabled visualization of a lesion on the correct side of the pituitary gland. In three patients, 7.0 T MRI detected a lesion on the correct side of the pituitary gland, while no lesion was visible at 1.5 T MRI.

Conclusion: The interobserver agreement of image assessment for 7.0 T MRI in patients with Cushing's disease was good, and lesions were detected more accurately with 7.0 T MRI.

Key points: Interobserver agreement for lesion detection on 1.5 T MRI was good; Interobserver agreement for lesion detection on 7.0 T MRI was good; 7.0 T enabled confirmation of unclear lesions at 1.5 T; 7.0 T enabled visualization of lesions not visible at 1.5 T.

Show MeSH
Related in: MedlinePlus