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Accuracy of Diffusion-Weighted Imaging-Magnetic Resonance in Differentiating Functional From Non-Functional Pituitary Macro-Adenoma and Classification of Tumor Consistency Publisher Pubmed



Sanei Taheri M1 ; Kimia F1 ; Mehrnahad M1 ; Saligheh Rad H2 ; Haghighatkhah H1 ; Moradi A3 ; Kazerooni AF2 ; Alviri M2 ; Absalan A4
Authors
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Authors Affiliations
  1. 1. Department of Radiology, Shahid Beheshti University of Medical Sciences, Iran
  2. 2. Quantitative MR Imaging and Spectroscopy Group (QMISG), Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Iran
  3. 3. Department of Pathology, Shahid Beheshti University of Medical Sciences, Iran
  4. 4. Department of Medical Laboratory Sciences, Khomein University of Medical Sciences, Markazi Province, Iran

Source: Neuroradiology Journal Published:2019


Abstract

Purpose: The purpose of this study was to determine the accuracy of selected first or second-order histogram features in differentiation of functional types of pituitary macro-adenomas. Materials and methods: Diffusion-weighted imaging magnetic resonance imaging was performed on 32 patients (age mean±standard deviation = 43.09 ± 11.02 years; min = 22 and max = 65 years) with pituitary macro-adenoma (10 with functional and 22 with non-functional tumors). Histograms of apparent diffusion coefficient were generated from regions of interest and selected first or second-order histogram features were extracted. Collagen contents of the surgically resected tumors were examined histochemically using Masson trichromatic staining and graded as containing <1%, 1–3%, and >3% of collagen. Results: Among selected first or second-order histogram features, uniformity (p = 0.02), 75th percentile (p = 0.03), and tumor smoothness (p = 0.02) were significantly different between functional and non-functional tumors. Tumor smoothness > 5.7 × 10−9 (area under the curve = 0.75; 0.56–0.89) had 70% (95% confidence interval = 34.8–93.3%) sensitivity and 33.33% (95% confidence interval = 14.6–57.0%) specificity for diagnosis of functional tumors. Uniformity ≤179.271 had a sensitivity of 60% (95% confidence interval = 26.2–87.8%) and specificity of 90.48% (95% confidence interval = 69.6–98.8%) with area under the curve = 0.76; 0.57–0.89. The 75th percentile >0.7 had a sensitivity of 80% (95% confidence interval = 44.4–97.5%) and specificity of 66.67% (95% confidence interval = 43.0–85.4%) for categorizing tumors to functional and non-functional types (area under the curve = 0.74; 0.55–0.88). Using these cut-offs, smoothness and uniformity are suggested as negative predictive indices (non-functional tumors) whereas 75th percentile is more applicable for diagnosis of functional tumors. Conclusion: First or second-order histogram features could be helpful in differentiating functional vs non-functional pituitary macro-adenoma tumors. © The Author(s) 2018.