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Magnetic resonance imaging and histology correlation in Cushing's disease
Affiliations- Department of Neurosurgery and Neurooncology, 1st Faculty of Medicine, Charles University and Central Military Hospital, Prague
- Department of Radiology, Central Military Hospital, Prague
- Department of Neurosurgery, Faculty Hospital, Ústí nad Labem
- 3rd Department of Medicine, 1st Faculty of Medicine, Charles University, Prague
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Abstract
We continuously look for new techniques to improve the radicality of resection and to eliminate the negative effects of surgery. One of the methods that has been implemented in the perioperative management of Cushing's disease was the combination of three magnetic resonance imaging (MRI) sequences: SE, SPGR and fSPGR.
Material and methodsWe enrolled 41 patients (11 males, 30 females) diagnosed with Cushing's disease. A 3D tumour model with a navigation console was developed using each SPGR, fSPGR and SE sequence. The largest model was then used. In all cases, a standard four-handed, bi-nostril endoscopic endonasal technique was used. Endocrinological follow-up evaluation using morning cortisol sampling was performed for 6–34 months in our study.
ResultsIn total, 36 patients (88%) were disease-free following surgery. Our results indicate we achieved 100% sensitivity of MR. Overall, the conformity of at least one donor site, as compared with the places designated on MR, was in 78% of patients. We searched the place of compliance in individual locations. There is a consensus in individual locations in 63 of the 123 cases (or 56%). The correlation gamma function at a 5% significance level was then 0.27.
DiscussionThe combination of MR sequences (SE, SPGR, fSPGR), neuronavigation system and iMRI led to increased sensitivity of up to 100%. Specificity reached 56% in our study.
ConclusionWe found a high success rate in surgical procedure in terms of the correlation between MR findings and histology, which leads to remission of Cushing's disease.
Abstract
We continuously look for new techniques to improve the radicality of resection and to eliminate the negative effects of surgery. One of the methods that has been implemented in the perioperative management of Cushing's disease was the combination of three magnetic resonance imaging (MRI) sequences: SE, SPGR and fSPGR.
Material and methodsWe enrolled 41 patients (11 males, 30 females) diagnosed with Cushing's disease. A 3D tumour model with a navigation console was developed using each SPGR, fSPGR and SE sequence. The largest model was then used. In all cases, a standard four-handed, bi-nostril endoscopic endonasal technique was used. Endocrinological follow-up evaluation using morning cortisol sampling was performed for 6–34 months in our study.
ResultsIn total, 36 patients (88%) were disease-free following surgery. Our results indicate we achieved 100% sensitivity of MR. Overall, the conformity of at least one donor site, as compared with the places designated on MR, was in 78% of patients. We searched the place of compliance in individual locations. There is a consensus in individual locations in 63 of the 123 cases (or 56%). The correlation gamma function at a 5% significance level was then 0.27.
DiscussionThe combination of MR sequences (SE, SPGR, fSPGR), neuronavigation system and iMRI led to increased sensitivity of up to 100%. Specificity reached 56% in our study.
ConclusionWe found a high success rate in surgical procedure in terms of the correlation between MR findings and histology, which leads to remission of Cushing's disease.
Keywords
Pituitary adenoma, Endoscopic resection, Magnetic resonance imaging
About this articleTitle
Magnetic resonance imaging and histology correlation in Cushing's disease
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
45-52
Page views
381
Article views/downloads
701
DOI
10.1016/j.pjnns.2016.10.005
Bibliographic record
Neurol Neurochir Pol 2017;51(1):45-52.
Keywords
Pituitary adenoma
Endoscopic resection
Magnetic resonance imaging
Authors
Václav Masopust
David Netuka
Vladimír Beneš
Martin Májovský
Tomáš Belšán
Ondřej Bradáč
Daniel Hořínek
Mikuláš Kosák
Václav Hána
Michal Kršek
