TY - JOUR T1 - Pituitary-Targeted Dynamic Contrast-Enhanced Multisection CT for Detecting MR Imaging–Occult Functional Pituitary Microadenoma JF - American Journal of Neuroradiology JO - Am. J. Neuroradiol. SP - 904 LP - 908 DO - 10.3174/ajnr.A4220 VL - 36 IS - 5 AU - M. Kinoshita AU - H. Tanaka AU - H. Arita AU - Y. Goto AU - S. Oshino AU - Y. Watanabe AU - T. Yoshimine AU - Y. Saitoh Y1 - 2015/05/01 UR - http://www.ajnr.org/content/36/5/904.abstract N2 - BACKGROUND AND PURPOSE: Although resection of a tumor by trans-sphenoidal surgery is considered the criterion standard for successful surgical treatment of functional pituitary microadenoma, MR imaging occasionally fails to visualize and identify the tumor and supplementary imaging modalities are necessary. We tested the possibility of dynamic contrast-enhanced multisection CT of the pituitary gland accompanying image reconstruction of contrast agent dynamics to identify the localizations of microadenomas and compared the diagnostic performance with conventional pituitary-targeted MR imaging. MATERIALS AND METHODS: Twenty-eight patients with surgically confirmed functional pituitary microadenomas (including growth hormone–, adrenocorticotropic hormone–, and prolactin-secreting adenomas) who underwent pituitary-targeted dynamic contrast-enhanced multisection CT were retrospectively investigated. We undertook image reconstruction of the dynamics of the contrast agent around the pituitary gland in a voxelwise manner, visualizing any abnormality and enabling qualification of contrast dynamics within the tumor. RESULTS: Fifteen cases were correctly diagnosed by MR imaging, while dynamic contrast-enhanced multisection CT correctly diagnosed 26 cases. The accuracy of localization was markedly better for adrenocorticotropic hormone–secreting microadenomas, increasing from 32% on MR imaging to 85% by dynamic contrast-enhanced multisection CT. Compared with the normal pituitary gland, adrenocorticotropic hormone–secreting adenoma showed the least difference in contrast enhancement of the different functional microadenomas. Images acquired at 45–60 seconds after contrast agent injection showed the largest difference in contrast enhancement between an adenoma and the normal pituitary gland. CONCLUSIONS: Dynamic contrast-enhanced multisection CT combined with image reconstruction of the contrast-enhanced dynamics holds promise in detecting MR imaging–occult pituitary microadenomas. ACTHadrenocorticotropic hormoneAUCarea under the curveDCEdynamic contrast-enhancedMCTmultisection CTPRLprolactinrAUCrelative AUC ER -