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Differentiating between non-functioning pituitary macroadenomas and sellar meningiomas using ADC.

Jing Zhang1,2,3, Zhiyong Zhao1,2,3, Li Dong4

  • 1Department of Radiology, Lanzhou University Second Hospital, Lanzhou, China.

Endocrine Connections
|October 28, 2020
PubMed
Summary

Apparent diffusion coefficient (ADC) values can help differentiate non-functioning pituitary macroadenomas (NFPMAs) from sellar meningiomas. Combining ADCmax values with clinicoradiological features offers high accuracy for diagnosis.

Keywords:
ADCDWIMRImeningiomaspituitary macroadenoma

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Area of Science:

  • Radiology
  • Oncology
  • Neurosurgery

Background:

  • Non-functioning pituitary macroadenomas (NFPMAs) and sellar meningiomas share overlapping imaging features on routine MRI.
  • Distinguishing between these sellar tumors is challenging, particularly when meningiomas invade the pituitary fossa.

Purpose of the Study:

  • To differentiate NFPMAs from sellar meningiomas using apparent diffusion coefficient (ADC) values and MRI characteristics.
  • To evaluate the diagnostic performance of ADC parameters in distinguishing these two tumor types.

Main Methods:

  • Retrospective review of 60 NFPMAs and 52 sellar meningiomas confirmed by pathology.
  • Analysis of routine MRI and diffusion-weighted imaging (DWI) data, including ADCmax, ADCmean, and ADCmin values.
  • Comparison of tumor characteristics using statistical tests and receiver operating characteristic (ROC) curve analysis.

Main Results:

  • NFPMAs exhibited significantly higher ADCmax, ADCmean, and ADCmin values than sellar meningiomas (P < 0.001).
  • ADCmax achieved an AUC of 0.896 with 88.7% accuracy for differentiation.
  • A combination of ADCmax and clinicoradiological features yielded the highest discrimination ability (AUC = 0.981, accuracy = 96.9%).

Conclusions:

  • ADCmax values, in conjunction with clinicoradiological features, provide a reliable quantitative method for differentiating NFPMAs and sellar meningiomas.
  • This combined approach enhances diagnostic accuracy and may assist in surgical planning.