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Diffusion-weighted imaging for predicting tumor consistency and extent of resection in patients with pituitary adenoma

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Abstract

This study aimed to investigate the role of diffusion-weighted imaging (DWI) in predicting tumor consistency, extent of surgical resection, and recurrence in pituitary adenoma (PA). We reviewed a prospectively collected database of surgically treated PA between March 2016 and October 2017. Predictors for extent of resection and recurrence/progression were assessed with logistic and Cox regression analysis. Of the 183 patients, the tumor consistency was found soft in 107 (58.5%) patients, intermediate in 41 (22.4%) patients, and hard in 35 (19.1%) patients. The mean of ADC ratio was 0.92 ± 0.22 for hard tumor, 1.03 ± 0.22 for intermediate tumor, and 1.41 ± 0.62 for soft tumor (P < 0.001). The mean collagen content was 25.86% ± 15.00% for hard tumor, 16.05% ± 9.90% for intermediate tumor, and 5.00% ± 6.00% for soft tumor (P < 0.001). Spearman analysis showed a significant correlation between ADC ratio and collagen content (ρ = − 0.367; P < 0.001). Gross-total resection (GTR) was obtained in 68.3% of patients, and multivariable logistic regression analysis showed that ADC ratio (OR, 12.135; 95% CI, 4.001–36.804; P < 0.001), giant PA (OR, 0.233; 95% CI, 0.105–0.520; P < 0.001), and invasion (OR, 0.459; 95% CI, 0.220–0.960; P = 0.039) were significantly predictive of GTR. Twenty-seven (14.8%) patients suffered recurrence/progression in the mean follow-up of 35.14 months. Invasion (HR, 2.728; 95% CI, 1.262–5.899; P = 0.011) was identified as independent predictors of recurrence/progression. ADC ratio of DWI could be used for preoperative assessment of tumor consistency, tumor collagen content, and extent of surgical resection, which might be useful in preoperative planning for patients with PA.

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Data availability

Data of this study are available from the corresponding author upon reasonable request.

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Acknowledgments

The authors would like to thank Dr. Zhongliang Hu and Dr. Zhenghao Deng of the Department of Pathology at Xiangya hospital for their assistance with the histopathological assessment.

Funding

This study was funded by the Natural Science Foundation of Hunan Province of China (Grant No.2018jj6139) and the Innovation-oriented Provinces Construction Project of Hunan Province (Grant No. 2019ZK4004).

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Authors and Affiliations

  1. Department of Neurosurgery, Xiangya Hospital, Central South University, No.87 Xiangya Road, Kaifu District, Changsha, 410008, China

    Wei Ding, Zheng Huang, Mingyu Zhang & Zhenyan Li

  2. Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410008, China

    Gaofeng Zhou & Lang Li

  3. National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, China

    Zhenyan Li

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  1. Wei Ding
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Contributions

W D, Z H, and ZY L contributed to the study conception and design. W D, Z H, and MY Z collected clinical data.GF Z and L L collected radiological data. W D and Z H performed the statistical analysis and drafted the manuscript. All authors contributed to the interpretation of results, all revised the manuscript critically for important intellectual content, and all approved the final manuscript. ZY L is the guarantor.

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Correspondence to Zhenyan Li.

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The authors declare that they have no conflict of interest.

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The current study was approved by the ethical committee of our hospital.

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Informed consent was obtained from all enrolled patients.

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Co-first author: Wei Ding and Zheng Huang contribute equally to this work.

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Ding, W., Huang, Z., Zhou, G. et al. Diffusion-weighted imaging for predicting tumor consistency and extent of resection in patients with pituitary adenoma. Neurosurg Rev 44, 2933–2941 (2021). https://doi.org/10.1007/s10143-020-01469-y

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