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Feasibility of high-resolution pituitary MRI at 7.0 tesla

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Abstract

Objectives

Since the pituitary gland measures 3-8 mm, imaging with the highest possible spatial resolution is important for the detection of even smaller lesions such as those seen in Cushing's disease. In the current feasibility study, we tested a multi-sequence MRI protocol to visualize the pituitary gland in high resolution at 7.0 Tesla (7.0 T).

Methods

Ten healthy volunteers were examined with a 7.0 T pituitary gland protocol. The protocol consisted of a T1-weighted magnetization-prepared inversion recovery (MPIR) turbo spin-echo (TSE) sequence and a T2-weighted TSE sequence. Additionally, this protocol was tested in five patients with clinical and biochemical suspicion of a microadenoma.

Results

The dedicated protocol was successful in visualizing normal pituitary anatomy. At 7.0 T compared to 1.5 T, four times as many slices covered the pituitary gland in sagittal and coronal direction. In three patients, a lesion was diagnosed at 7.0 T, and was confirmed by histopathology to be a microadenoma.

Conclusion

Head-to-head comparisons of 7.0 T with 1.5 T and 3.0 T are needed with larger samples of patients and with imaging times feasible for clinical settings. However, the current study suggests that high-resolution 7.0 T MRI of the pituitary gland may provide new perspectives when used as a second-line diagnostic examination in the specific context of Cushing's disease.

Key Points

• 7.0 T MRI enables ultra-high-resolution imaging of the pituitary gland.

• 7.0 T MRI is appropriate to visualize normal pituitary gland anatomy.

• The pituitary protocol consists of a T 1 -MPIR-TSE and a T 2 -TSE sequence.

• In four patients, a suspected ACTH-producing microadenoma was visualized at 7.0 T.

• Histopathology confirmed three of four lesions to be ACTH-producing microadenomas.

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Fig. 1
Fig. 2

Abbreviations

ACTH :

Adrenocorticotropic hormone

CNR :

Contrast-to-noise ratio

IRB :

Institutional review board

MPIR :

Magnetization-prepared inversion recovery

MRI :

Magnetic resonance imaging

SAR :

Specific absorption rate

SNR :

Signal-to-noise ratio

T :

Tesla

TFE :

Turbo field echo

TSE :

Turbo spin echo

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Acknowledgements

The scientific guarantor of this publication is J. Hendrikse. The authors of this manuscript declare relationships with the following companies: Philips Healthcare, Best, the Netherlands. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: primarily prospective, diagnostic or prognostic study, performed at one institution.

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Authors and Affiliations

  1. Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, Postbox 85500, 3508 GA, Utrecht, The Netherlands

    Alexandra A. J. de Rotte, Anja G. van der Kolk, Dik Rutgers, Fredy Visser, Peter R. Luijten & Jeroen Hendrikse

  2. Department of Internal Medicine (Section of Endocrinology), University Medical Center Utrecht, Utrecht, The Netherlands

    Pierre M. J. Zelissen

  3. Philips Healthcare, Best, The Netherlands

    Fredy Visser

Authors
  1. Alexandra A. J. de Rotte
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  2. Anja G. van der Kolk
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Correspondence to Alexandra A. J. de Rotte.

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de Rotte, A.A.J., van der Kolk, A.G., Rutgers, D. et al. Feasibility of high-resolution pituitary MRI at 7.0 tesla. Eur Radiol 24, 2005–2011 (2014). https://doi.org/10.1007/s00330-014-3230-x

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  • DOI: https://doi.org/10.1007/s00330-014-3230-x

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