フククラ　ヨシヒコ   Yoshihiko Fukukura   福倉　良彦    所属   川崎医科大学  医学部 臨床医学　機能・代謝画像診断学    職種   教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Quantitative pharmacokinetic analysis of high-temporal-resolution dynamic contrast-enhanced MRI to differentiate the normal-appearing pituitary gland from pituitary macroadenoma.
掲載誌名	正式名：Japanese journal of radiology 略　 称：Jpn J Radiol ISSNコード：1867108X/18671071
掲載区分	国外
巻・号・頁	38(7),pp.649-657
著者・共著者	Kiyohisa Kamimura, Masanori Nakajo, Tomohide Yoneyama, Manisha Bohara, Ryota Nakanosono, Shingo Fujio, Takashi Iwanaga, Marcel Dominik Nickel, Hiroshi Imai, Yoshihiko Fukukura, Takashi Yoshiura
発行年月	2020/07
概要	PURPOSE:To evaluate the usefulness of high-temporal-resolution dynamic contrast-enhanced (DCE) MRI and quantitative pharmacokinetic analysis to differentiate the normal-appearing pituitary gland from a pituitary macroadenoma.MATERIALS AND METHODS:Twenty-seven patients with macroadenomas underwent preoperative DCE-MRI with a temporal resolution of 5 s using compressed sensing to obtain pharmacokinetic parameters. Two independent observers localized the normal-appearing pituitary gland on post-contrast T1-weighted images before and after referring to the corresponding Ktrans maps. Agreements between the localizations and intraoperative findings were evaluated using the kappa statistics. The Mann-Whitney U test was used to compare the pharmacokinetic parameters of the normal-appearing pituitary gland and adenoma.RESULTS:For both observers, the agreement between the MRI-based localization and the intraoperative findings increased after referring to the Ktrans maps (observer 1, 0.930-1; observer 2, 0.636-0.855). The normal-appearing pituitary gland had significantly higher Ktrans [/min] (1.50 ± 0.80 vs 0.58 ± 0.49, P < 0.0001), kep [/min] (3.19 ± 1.29 vs 2.15 ± 1.18, P = 0.0049), and ve (0.43 ± 0.15 vs 0.25 ± 0.17, P = 0.0003) than adenoma.CONCLUSION:High-temporal-resolution DCE-MRI and quantitative pharmacokinetic analysis help accurately localize the normal-appearing pituitary gland in patients with macroadenomas. The normal-appearing pituitary gland was characterized by higher Ktrans, kep, and ve than macroadenoma. Dynamic contrast-enhanced MRI with high-temporal-resolution using compressed sensing was used for quantitative pharmacokinetic analysis of pituitary macroadenomas. An observer study, the use of Ktrans maps improved accuracy in localizing the normal-appearing pituitary gland. As compared to an adenoma, the normal-appearing pituitary gland had significantly higher Ktrans, kep, and ve values.
DOI	10.1007/s11604-020-00942-4
PMID	32162178