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Quantitative visual pathway abnormalities predict visual field defects in patients with pituitary adenomas: a
Lihong Liang1,2, Hai Lin2,3, Fan Lin4,5
1Department of Radiology, Shenzhen Second People's Hospital, the First Affiliated Hospital of Shenzhen University, Shenzhen, 518035, Guangdong, China.
European Radiology
|April 24, 2021
Summary
Diffusion spectrum imaging (DSI) can quantitatively detect visual pathway abnormalities in pituitary adenoma patients. This advanced technique helps predict the severity of visual field defects, aiding in diagnosis.
Area of Science:
- Neuroimaging
- Ophthalmology
- Radiology
Background:
- Pituitary adenomas can cause visual pathway compression, leading to visual field defects (VFD).
- Accurate assessment of VFD severity is crucial for patient management.
- Conventional MRI may not fully capture subtle visual pathway abnormalities.
Purpose of the Study:
- To evaluate the clinical applicability of Diffusion Spectrum Imaging (DSI) for quantitative detection of visual pathway abnormalities.
- To predict the degree of visual field defects (VFD) in patients with pituitary adenomas using DSI.
- To assess the diagnostic potential of DSI in differentiating VFD severity.
Main Methods:
- Sixty-five pituitary adenoma patients and 33 controls underwent conventional MRI and DSI with high-angular-resolution fiber tracking.
- Quantitative assessments included chiasmal lift, VFD, and DSI parameters (QA, GFA) of the optic nerve, tract, and radiation.
- Support vector machine classifiers were developed using 5-fold cross-validation to predict VFD severity.
Main Results:
- Significant differences in quantitative anisotropy (QA) and generalized fractional anisotropy (GFA) were observed in the optic nerve and tract between patients and controls (p < 0.05).
- DSI parameters correlated significantly with chiasmal lift distance and VFD degree (p < 0.05).
- Classifiers accurately discriminated between mild and severe VFD with 83% accuracy, 78% sensitivity, and 86% specificity.
Conclusions:
- DSI, utilizing high-angular-resolution fiber tracking, offers quantitative insights into visual pathway abnormalities.
- It shows potential as a diagnostic tool for assessing the degree of visual field defects in pituitary adenoma patients.
- Abnormal QA and GFA values in the optic nerve and tract are linked to VFD in these patients.
