Virtual magnetic resonance elastography has the feasibility to evaluate preoperative pituitary adenoma consistency
Open accessAbstract
Purpose: To evaluate the use of preoperative virtual Magnetic Resonance Elastography (vMRE) for patients undergoing transsphenoidal resection of pituitary adenomas (PA). Methods: Ten patients (60.2 ± 19.6 years; 8 males) were prospectively examined with the vMRE-method prior to transsphenoidal surgery. vMRE-images, reflecting tissue stiffness were reconstructed. From these images, histograms as well as the mean stiffness values over the tumor body were extracted. Finally, vMRE-data was compared with the PA consistency at surgery blinded to vMRE. Results: In all patients, successful vMRE-examination was performed enabling evaluation of even small PAs. For tumors with homogenous tissue, the mean stiffness value increased with surgical consistency grading. For heterogenous tumors, however, the mean stiffness value did not consistently reflect the grading at surgery. On the other hand, the vMRE-images and histograms were found to be able to characterize the tumor heterogeneity and display focal regions of high stiffness that were found to affect the surgery outcome in these PAs. The vMRE-images and histograms showed great promise in characterizing the consistency at surgery for these PAs. Conclusion: Evaluation of PA consistency in preparation for surgery seems to be feasible using the vMRE-method. Our findings also address the need for high resolution diagnostic methods that can non-invasively display focal regions of increased stiffness, as such regions may increase the difficulty of transsphenoidal PA-resection.
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In patients undergoing transsphenoidal surgery, preoperative vMRE stiffness and elasticity-histogram metrics correlated with surgeons' intraoperative impressions of tumor softness or firmness, with good feasibility and reproducibility.
“In patients undergoing transsphenoidal surgery, preoperative vMRE stiffness and elasticity-histogram metrics correlated with surgeons’ intraoperative impressions of tumor softness or firmness, with good feasibility and reproducibility (Lagerstrand et al., 2021).”
From 40 Years of diffusion MRI in the brain: From history to emerging frontiers (2026) · cites this paper as Lagerstrand et al., 2021
The Methods and Results describe preoperative vMRE in patients undergoing transsphenoidal surgery, comparison with surgeons’ consistency ratings, successful imaging in all patients, and excellent agreement in repeated stiffness measurements. However, the Results state that mean stiffness did not differ overall between surgical-consistency groups: it increased with grading only for homogeneous tumors, while histograms helped characterize heterogeneous tumors. The claim overstates the consistency of the relationship across patients. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMechanical stiffness is recognized by neurosurgeons as relevant to approach selection, resection strategy, and complication risk.
“Mechanical stiffness is recognized by neurosurgeons as relevant to approach selection, resection strategy, and complication risk (Lagerstrand et al., 2021).”
From 40 Years of diffusion MRI in the brain: From history to emerging frontiers (2026) · cites this paper as Lagerstrand et al., 2021
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Research works printed but not linked: 19
- [1]Rizzoli P Iuliano S Weizenbaum E Laws E Headache in patients with pituitary lesions: a longitudinal cohort study Neurosurgery 2016 78 3 316 323 10.1227/NEU.0000000000001067 26485333 · DOI
- [2]Scheithauer BW Gaffey TA Lloyd RV Sebo TJ Kovacs KT Horvath E Pathobiology of pituitary adenomas and carcinomas Neurosurgery 2006 59 2 341 353 10.1227/01.NEU.0000223437.51435.6E 16883174 · DOI
- [3]Penn DL Burke WT Laws ER Management of non-functioning pituitary adenomas: surgery Pituitary 2018 21 2 145 153 10.1007/s11102-017-0854-2 29280026 · DOI
- [4]Naganuma H Satoh E Nukui H Technical considerations of transsphenoidal removal of fibrous pituitary adenomas and evaluation of collagen content and subtype in the adenomas Neurol Med Chir (Tokyo) 2002 42 5 202 212 10.2176/nmc.42.202 12064154 · DOI
- [5]Snow RB Lavyne MH Lee BCP Morgello S Patterson RH Craniotomy versus trans-sphenoidal excision of large pituitary-tumors—the usefulness of magnetic-resonance-imaging in guiding the operative approach Neurosurgery 1986 19 1 59 64 10.1227/00006123-198607000-00008 3748338 · DOI
- [6]Zada G Du R Laws ER Jr Defining the "edge of the envelope": patient selection in treating complex sellar-based neoplasms via transsphenoidal versus open craniotomy J Neurosurg 2011 114 2 286 300 10.3171/2010.8.JNS10520 20815698 · DOI
- [7]Mahmoud OM Tominaga A Amatya VJ Ohtaki M Sugiyama K Sakoguchi T Role of PROPELLER diffusion-weighted imaging and apparent diffusion coefficient in the evaluation of pituitary adenomas Eur J Radiol 2011 80 2 412 417 10.1016/j.ejrad.2010.05.023 20580505 · DOI
- [8]Pierallini A Caramia F Falcone C Tinelli E Paonessa A Ciddio AB Pituitary macroadenomas: preoperative evaluation of consistency with diffusion-weighted MR imaging–initial experience Radiology 2006 239 1 223 231 10.1148/radiol.2383042204 16452397 · DOI
- [9]Snow RB Johnson CE Morgello S Lavyne MH Patterson RH Jr Is magnetic resonance imaging useful in guiding the operative approach to large pituitary tumors? Neurosurgery 1990 26 5 801 803 10.1227/00006123-199005000-00011 2352598 · DOI
- [10]Yamamoto J Kakeda S Shimajiri S Takahashi M Watanabe K Kai Y Tumor consistency of pituitary macroadenomas: predictive analysis on the basis of imaging features with contrast-enhanced 3D FIESTA at 3T AJNR Am J Neuroradiol 2014 35 2 297 303 10.3174/ajnr.A3667 23928139 PMC7965767 · DOI
- [11]Sack I Beierbach B Hamhaber U Klatt D Braun J Non-invasive measurement of brain viscoelasticity using magnetic resonance elastography NMR Biomed 2008 21 3 265 271 10.1002/nbm.1189 17614101 · DOI
- [12]Kruse SA Rose GH Glaser KJ Manduca A Felmlee JP Jack CR Jr Magnetic resonance elastography of the brain Neuroimage 2008 39 1 231 237 10.1016/j.neuroimage.2007.08.030 17913514 PMC2387120 · DOI
- [13]Green MA Bilston LE Sinkus R In vivo brain viscoelastic properties measured by magnetic resonance elastography NMR Biomed 2008 21 7 755 764 10.1002/nbm.1254 18457350 · DOI
- [14]Hughes JD Fattahi N Van Gompel J Arani A Ehman R Huston J 3rd Magnetic resonance elastography detects tumoral consistency in pituitary macroadenomas Pituitary 2016 19 3 286 292 10.1007/s11102-016-0706-5 26782836 PMC4860122 · DOI
- [15]Jakobsson S Olsson DS Andersson E Hallen T Krabbe D Olofsson AC Extended support within a person-centered practice after surgery for patients with pituitary tumors: protocol for a quasiexperimental study JMIR Res Protoc 2020 9 7 e17697 10.2196/17697 32706741 PMC7404015 · DOI
- [16]Le Bihan D Ichikawa S Motosugi U Diffusion and intravoxel incoherent motion mr imaging-based virtual elastography: a hypothesis-generating study in the liver Radiology 2017 285 2 609 619 10.1148/radiol.2017170025 28604279 · DOI · Paper page
- [17]Bahuleyan B Raghuram L Rajshekhar V Chacko AG To assess the ability of MRI to predict consistency of pituitary macroadenomas Br J Neurosurg 2006 20 5 324 326 10.1080/02688690601000717 17129884 · DOI
- [18]Thomas T Gopalakrishna C Thomas B Nair S Evaluation of consistency of pituitary macroadenoma using diffusion-weighted imaging in correlation with surgical findings Neurosurg Quat 2014 24 2 131 135 10.1097/WNQ.0b013e31828cc38d · DOI
- [19]Alimohamadi M Sanjari R Mortazavi A Shirani M Moradi Tabriz H Hadizadeh Kharazi H Predictive value of diffusion-weighted MRI for tumor consistency and resection rate of nonfunctional pituitary macroadenomas Acta Neurochir (Wien) 2014 156 12 2245 2252 10.1007/s00701-014-2259-6 25338532 · DOI
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Sorted by citations
Le Bihan, D. (2026) · Frontiers in Neuroscience · doi:10.3389/fnins.2026.1858655 · Cited by 1 · see citing works
40 Years of diffusion MRI in the brain: From history to emerging frontiers
Le Bihan, D. (2026) · Imaging Neuroscience · doi:10.1162/imag.a.1365
“Mechanical stiffness is recognized by neurosurgeons as relevant to approach selection, resection strategy, and complication risk ( Lagerstrand et al., 2021).”
- Authors
- Lagerstrand, K., Gaedes, N., Eriksson, S., Farahmand, D., De Coursey, E., Johansson, G., Jönsson, L., & Skoglund, T.
- Affiliations
- Sahlgrenska University Hospital (SE)
- Corresponding author
- Lagerstrand, Kerstin
- Venue
- Pituitary
- Published
- 2021-02-08
- Volume
- 24
- Issue
- 4
- Pages
- 530-541
- ISSN
- 1386-341X (ISSN-L)
- 1573-7403
- PMC
- PMC8270838
- OpenAlex
- W3127193604
- Cited by
- 43
- References
- 0
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 11 · 2023: 5 · 2022: 5 · 2021: 2
- FWCI
- 3.04
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Pituitary (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- the Swedish state under the agreement between the Swedish government and the country councils, the ALF-agreement
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Ultrasound Imaging and Elastography
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- pituitary adenoma, tumor consistency, tissue stiffness, transsphenoidal surgery, tumor heterogeneity, preoperative assessment, surgical difficulty prediction, non-invasive tumor characterization
- MeSH terms
- Adenoma, Adult, Aged, Feasibility Studies, Female, Humans, Magnetic Resonance Imaging, Male, Middle Aged, Pituitary Neoplasms, Treatment Outcome, Elasticity Imaging Techniques
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