Poster (9)

RESULTS Comparison between Dynamic contrast SE MRI and contrast enhanced VIBE MRI detection of microadenoma Finding Contrast enhanced VIBE Negative Suspicious Positive Total Dynamic contrast (Spin Echo) Negative 2 2 4 Suspicious 3 3 6 Positive 12 12 Total 2 3 17 22 *Six patients with macroadenomas visible on both MRI techniques were not included in the final analysis. Comparative images of 3 patients using both techniques CONCLUSION Post contrast VIBE-MRI technique is superior to conventional dynamic contrast SE-MRI technique for detection of pituitary microadenoma in Cushing’s disease. Sensitivity of Dynamic SE MRI : 55% Sensitivity of VIBE MRI : 77% BACKGROUND Imaging microadenomas in Cushing’s disease (CD) is a challenge: Yield of Pituitary MRI in detecting microadenomas is < 60%. Can VIBE technique offer a solution? • Based on Radio-frequency spoiled 3D GRE sequence, it takes up to 1 mm thin sections which can be useful for detecting small pituitary microadenomas • Uses partial fourier of zero filling in slice selection that improves spatial resolution • Provides faster acquisition, minimizes artifacts due to motion and vascular pulsation OBJECTIVE To compare the performance of dynamic contrast SE MRI technique and contrast enhanced VIBE technique in the diagnostic evaluation of ACTH secreting microadenomas in CD PATIENTS AND METHODOLOGY • 28 patients (21 F and 7 M) with ACTH dependent endogenous hypercortisolism and final diagnosis of CD (based on histopathology proof of adenoma and/or remission (partial/ complete) of hypercortisolism post surgery) treated over 2 yrs were included. • All patients underwent MRI imaging by both techniques simultaneously. • Cases with negative pituitary MRI underwent bilateral IPSS as a proof for pituitary origin of ACTH excess state. • Images were reviewed retrospectively by two independent radiologists who were blinded to clinical details and final diagnosis. Kasaliwal R Contrast Enhanced Volumetric Interpolated Breath Hold Examination (VIBE) Technique is Better than Dynamic Contrast Spin Echo Technique for MRI Detection of ACTH Secreting Pituitary Microadenomas *Kasaliwal R, Lila AR, Sarathi V, Jagtap VS, Budyal S, Bandgar TR, Menon PS, Shah NS Department of Endocrinology, Seth G.S. Medical College and King Edward Memorial Hospital, Parel, Mumbai, India *Email: [email protected] a-SE b-VIBE 1a 1b 2a 2b 3a 3b

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Transcript of Poster (9)

RESULTSComparison between Dynamic contrast SE MRI and

contrast enhanced VIBE MRI detection of microadenoma

FindingContrast enhanced VIBE

Negative Suspicious Positive Total

Dynamic contrast

(Spin Echo)

Negative 2 2 4

Suspicious 3 3 6

Positive 12 12

Total 2 3 17 22

*Six patients with macroadenomas visible on both MRI techniques were not included in the final analysis.

Comparative images of 3 patients using both techniques

CONCLUSIONPost contrast VIBE-MRI technique is superior to conventional dynamic contrast SE-MRI technique for detection of pituitary microadenoma in Cushing’s disease.

Sensitivity of Dynamic SE MRI : 55%Sensitivity of VIBE MRI : 77%

BACKGROUND

Imaging microadenomas in Cushing’s disease (CD) is a

challenge: Yield of Pituitary MRI in detecting microadenomas is

< 60%.

Can VIBE technique offer a solution?

• BasedonRadio-frequencyspoiled3DGREsequence,ittakes

up to 1 mm thin sections which can be useful for detecting

small pituitary microadenomas

• Uses partial fourier of zero filling in slice selection that

improves spatial resolution

• Providesfasteracquisition,minimizesartifactsdue to motion

and vascular pulsation

OBJECTIVE

To compare the performance of dynamic contrast SE MRI

technique and contrast enhanced VIBE technique in the

diagnostic evaluation of ACTH secreting microadenomas in CD

PATIENTS AND METHODOLOGY

• 28patients(21 F and 7 M) with ACTH dependent endogenous

hypercortisolism and final diagnosis of CD (based on

histopathology proof of adenoma and/or remission (partial/

complete) of hypercortisolism post surgery) treated over

2 yrs were included.

•All patients underwent MRI imaging by both techniques

simultaneously.

•Caseswith negative pituitaryMRI underwentbilateral IPSS

as a proof for pituitary origin of ACTH excess state.

• Images were reviewed retrospectively by two independent

radiologists who were blinded to clinical details and final

diagnosis. Kasaliwal R

Contrast Enhanced Volumetric Interpolated Breath Hold Examination (VIBE) Technique is Better than Dynamic Contrast Spin Echo Technique for MRI Detection of ACTH Secreting Pituitary Microadenomas*Kasaliwal R, Lila AR, Sarathi V, Jagtap VS, Budyal S, Bandgar TR, Menon PS, Shah NSDepartment of Endocrinology, Seth G.S. Medical College and King Edward Memorial Hospital, Parel, Mumbai, India *Email: [email protected]

a-SEb-VIBE