Utility of 7 Tesla MRI for Preoperative Planning of Endoscopic Endonasal Surgery for Pituitary Adenomas

John W. Rutland; Bradley N. Delman; Rebecca E. Feldman; Nadejda Tsankova; Hung-Mo Lin; Francesco Padormo; Raj K. Shrivastava; Priti Balchandani

doi:10.1055/s-0039-3400222

Journal of Neurological Surgery Part B: Skull Base, Table of Contents

J Neurol Surg B Skull Base 2021; 82(03): 303-312
DOI: 10.1055/s-0039-3400222

Original Article

Utility of 7 Tesla MRI for Preoperative Planning of Endoscopic Endonasal Surgery for Pituitary Adenomas

Authors

John W. Rutland

¹Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States

²Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Bradley N. Delman

¹Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States

³Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Rebecca E. Feldman

¹Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Nadejda Tsankova

⁴Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Hung-Mo Lin

⁵Department of Population Health Science and Policy, Mount Sinai Hospital, New York, New York, United States
Francesco Padormo

¹Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States

⁶Department of Medical Physics, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
Raj K. Shrivastava‡^*

²Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Priti Balchandani‡^*

¹Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States

Abstract

Objective There is increasing interest in investigating the utility of 7 Tesla (7 T) magnetic resonance imaging (MRI) for imaging of skull base tumors. The present study quantifies visualization of tumor features and adjacent skull base anatomy in a homogenous cohort of pituitary adenoma patients.

Methods Eighteen pituitary adenoma patients were scanned at 7 T in this prospective study. All patients had reference standard-of-care clinical imaging at either 3 T (7/18, 39%) or 1.5 T (11/18, 61%). Visualization of tumor features and conspicuity of arteries and cranial nerves (CNs) was rated by an expert neuroradiologist on 7 T and clinical field strength MRI. Overall image quality and severity of image artifacts were also characterized and compared.

Results Ability to visualize tumor features did not differ between 7 T and lower field MRI. Cranial nerves III, IV, and VI were better detected at 7 T compared with clinical field strength scans. Cranial nerves III, IV, and VI were also better detected at 7 T compared with only 1.5 T, and CN III was better visualized at 7 T compared with 3 T MRI. The ophthalmic arteries and posterior communicating arteries (PCOM) were better detected at 7 T compared with clinical field strength imaging. The 7 T also provided better visualization of the ophthalmic arteries compared with 1.5 T scans.

Conclusion This study demonstrates that 7 T MRI is feasible at the skull base and identifies various CNs and branches of the internal carotid artery that were better visualized at 7 T. The 7 T MRI may offer important preoperative information that can help to guide resection of pituitary adenoma and reduce operative morbidity.

Keywords

7 Telsa MRI - pituitary adenoma - endoscopic endonasal surgery - skull base anatomy - neurosurgery

Full Text

References

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