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Published on: January 17, 2018
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.
Introduction And Aim:
It is difficult to distinguish between non-functioning pituitary macroadenomas (NFPMAs) and sellar meningiomas because of their overlapping imaging manifestations on routine MRI, especially in cases of meningiomas growing into the saddle. Here, we aimed to differentiate between these two tumors using apparent diffusion coefficient (ADC) values and MRI characteristics.
Methods:
A total of 60 NFPMA and 52 sellar meningioma cases confirmed by the pathological analysis were retrospectively reviewed. All patients were examined via routine MRI and diffusion-weighted imaging (DWI) before undergoing surgery. The clinical characteristics, MRI characteristics, and max ADC (ADCmax), average ADC (ADCmean), and minimum ADC (ADCmin) values were compared between the two tumors via Chi-square test and two sample t-tests. Receiver operating characteristic (ROC) curve and binary logistic regression analyses were conducted to determine the discrimination ability.
Results:
The ADCmax, ADCmean, and ADCmin values were significantly higher in NFPMAs compared to sellar meningiomas (P < 0.001 for all). Among ADC values, ADCmax demonstrated good performance with an AUC of 0.896 (95% CI, 0.823-0.969) and accuracy of 88.7%. A cut-off value of 0.97 × 10-3 mm2/s was used for ADCmax for differentiation between tumors. A combination of ADCmax values and clinicoradiological features showed the best discrimination ability for differential diagnosis between the two tumors, with an AUC of 0.981 (95% CI, 0.958-1.000) and accuracy of 96.9%.
Conclusion:
A combination of ADCmax and clinicoradiological features demonstrates good discrimination ability and high accuracy for differentiation between NFPMAs and sellar meningiomas, and is a potential quantitative tool to aid in the selection of surgical techniques.
Insights
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.
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.
