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Do We Need Gadolinium-Based Contrast Agents for Routine MRI Surveillance of Unoperated Pituitary Macroadenoma?

A A Alali1, P B Hanagandi2, P J Maralani3

  • 1From the Division of Neuroradiology (A.A.A.), King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia aliak@ksau-hs.edu.sa.

AJNR. American Journal of Neuroradiology
|June 23, 2022
PubMed
Abstract

Insights

Gadolinium-based contrast agents may not be necessary for pituitary macroadenoma follow-up MRIs. Omitting these agents can reduce costs, shorten scan times, and avoid gadolinium deposition risks.

Area of Science:

  • Radiology
  • Neuroimaging
  • Oncology

Background:

  • Gadolinium-based contrast agents (GBCAs) increase MRI costs and scan times.
  • Concerns exist regarding gadolinium deposition, especially with frequent MRI follow-ups.
  • Pituitary macroadenomas require regular monitoring via MRI.

Purpose of the Study:

  • To evaluate the necessity of GBCAs for follow-up MR imaging of unoperated pituitary macroadenomas.
  • To determine if non-contrast MRI sequences are sufficient for monitoring tumor progression.

Main Methods:

  • Retrospective analysis of 105 patients with unoperated pituitary macroadenomas.
  • Comparison of coronal T2-weighted imaging (T2WI) with contrast-enhanced T1-weighted imaging (T1 postcontrast).
  • Assessment of craniocaudal dimension, cavernous sinus invasion, and optic pathway compression using intraclass correlation coefficient and κ statistics.

Main Results:

  • Excellent agreement (ICC = 0.96) for craniocaudal dimensions between T2WI and T1 postcontrast images.
  • Almost-perfect agreement (κ = 0.95 and 0.84) for cavernous sinus invasion and optic pathway compression, respectively.
  • High concordance suggests T2WI alone is reliable for key measurements.

Conclusions:

  • MRI without GBCAs is a viable option for pituitary macroadenoma follow-up.
  • Eliminating GBCAs reduces examination costs and acquisition time.
  • This approach mitigates potential risks associated with gadolinium deposition.

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