Purpose

Pre-surgical information about tumor consistency could facilitate neurosurgical planning. This study used multi-dynamic-multi-echo (MDME)-based relaxometry for the quantitative determination of pituitary tumor consistency, with the aim of predicting lesion resectability.

Methods

Seventy-two patients with suspected pituitary adenomas, who underwent preoperative 3 T MRI between January 2020 and January 2022, were included in this prospective study. Lesion-specific T1-/T2-relaxation times (T1R/T2R) and proton density (PD) metrics were determined. During surgery, data about tumor resectability were collected. A Receiver Operating Characteristic (ROC) curve analysis was performed to investigate the diagnostic performance (sensitivity/specificity) for discriminating between easy- and hard-to-remove by aspiration (eRAsp and hRAsp) lesions. A Mann-Whitney-U-test was done for group comparison.

Results

A total of 65 participants (mean age, 54 years ± 15, 33 women) were enrolled in the quantitative analysis. Twenty-four lesions were classified as hRAsp, while 41 lesions were assessed as eRAsp. There were significant differences in T1R (hRAsp: 1221.0 ms ± 211.9; eRAsp: 1500.2 ms ± 496.4; p = 0.003) and T2R (hRAsp: 88.8 ms ± 14.5; eRAsp: 137.2 ms ± 166.6; p = 0.03) between both groups. The ROC analysis revealed an area under the curve of 0.72 (95% CI: 0.60–0.85) at p = 0.003 for T1R (cutoff value: 1248 ms; sensitivity/specificity: 78%/58%) and 0.66 (95% CI: 0.53–0.79) at p = 0.03 for T2R (cutoff value: 110 ms; sensitivity/specificity: 39%/96%).

Conclusion

MDME-based relaxometry enables a non-invasive, pre-surgical characterization of lesion consistency and, therefore, provides a modality with which to predict tumor resectability.

中文翻译：

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基于多动态多回波的 MRI 用于术前确定鞍区肿瘤一致性：预测病变可切除性的定量方法

目的

有关肿瘤一致性的术前信息可以促进神经外科计划。本研究使用基于多动态多回波（MDME）的松弛测量法定量测定垂体肿瘤的一致性，目的是预测病变的可切除性。

方法

这项前瞻性研究纳入了 2020 年 1 月至 2022 年 1 月期间接受术前 3 T MRI 的 72 名疑似垂体腺瘤患者。确定病变特异性 T1-/T2-弛豫时间 (T1R/T2R) 和质子密度 (PD) 指标。在手术期间，收集有关肿瘤可切除性的数据。进行受试者操作特征 (ROC) 曲线分析，以研究区分容易和难以通过抽吸去除（eRAsp 和 hRAsp）病变的诊断性能（敏感性/特异性）。进行曼惠特尼 U 检验以进行组间比较。

结果

共有 65 名参与者（平均年龄，54 岁 ± 15，其中 33 名女性）参与了定量分析。 24 个病变被分类为 hRAsp，41 个病变被评估为 eRAsp。 两组之间的T1R（hRAsp：1221.0 ms ± 211.9；eRAsp：1500.2 ms ± 496.4； p  = 0.003）和 T2R（hRAsp：88.8 ms ± 14.5；eRAsp：137.2 ms ± 166.6；p = 0.03）存在显着差异。 ROC 分析显示，T1R 的曲线下面积为 0.72（95% CI：0.60–0.85），p  = 0.003（截止值：1248 ms；敏感性/特异性：78%/58%）和 0.66（95% CI： 0.53–0.79）， T2R 的p  = 0.03（截止值：110 ms；敏感性/特异性：39%/96%）。

结论

基于 MDME 的松弛测量能够对病变一致性进行非侵入性手术前表征，因此提供了一种预测肿瘤可切除性的方式。