Added Value of Dynamic Contrast-Enhanced Magnetic Resonance Imaging in Predicting Response to Somatostatin Analogs in Acromegaly Patients

Özet

AIM: To investigate the added value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) sequences in predictingsomatostatin analog (SSA) responses in patients with acromegaly.MATERIAL and METHODS: This study included 55 active acromegaly patients with macroadenoma. Mean and maximum signalintensities were measured using region of interests in T2-weighted (T2W) and DCE-MRI sequences. Semi-quantitative valuesindicating relative signal intensity ratios and contrast-enhanced kinetics were obtained. Bivariate and multivariate analyses wereused to determine whether the pathological granulation pattern of adenomas (dense versus others) was associated with patients’demographic variables and semi-quantitative MRI parameters.RESULTS: Three parameters formed the logistic model, χ2(3)=23.278, p<0.0001: age (odds ratio [OR]=1.08), hypointensity ofadenomas in T2W images (OR=15.45), and high maximum enhancement ratio in the second interval (ER2max) values (OR=2195.74).The overall accuracy of this model was 85.45% with an area under the curve of 0.880. Sensitivity, specificity, positive predictive, andnegative predictive values of the model were 68.75%, 92.31%, 78.58%, and 87.8%, respectively.CONCLUSION: In patients with newly diagnosed acromegaly, the model created based on the relative T2W signal intensity, patient’sage, and ER2max parameter from DCE-MRI sequences might be used to more accurately predict SSA responses.