PT  - JOURNAL ARTICLE
AU  - Mark, Ian T.
AU  - Welker, Kirk
AU  - Erickson, Dana
AU  - Johnson, Derek R.
AU  - Bathla, Girish
AU  - Messina, Steven
AU  - Farnsworth, Paul J.
AU  - Van Gompel, Jamie
TI  - 7T MRI for Cushing Disease: A Single-Institution Experience and Literature Review
AID  - 10.3174/ajnr.A8209
DP  - 2024 Jul 01
TA  - American Journal of Neuroradiology
PG  - 971--976
VI  - 45
IP  - 7
4099  - http://www.ajnr.org/content/45/7/971.short
4100  - http://www.ajnr.org/content/45/7/971.full
SO  - Am. J. Neuroradiol.2024 Jul 01; 45
AB  - BACKGROUND AND PURPOSE: Cushing disease is typically caused by a pituitary adenoma that frequently is small and challenging to detect on conventional MR imaging. High-field-strength 7T MR imaging can leverage increased SNR and contrast-to-noise ratios compared with lower-field-strength MR imaging to help identify small pituitary lesions. We aimed to describe our institutional experience with 7T MR imaging in patients with Cushing disease and perform a review of the literature.MATERIALS AND METHODS: We performed a retrospective analysis of 7T MR imaging findings in patients with pathology-proved Cushing disease from a single institution, followed by a review of the literature on 7T MR imaging for Cushing disease.RESULTS: Our institutional experience identified Cushing adenomas in 10/13 (76.9%) patients on 7T; however, only 5/13 (38.5%) lesions were discrete. Overall, the imaging protocols used were heterogeneous in terms of contrast dose as well as type of postcontrast T1-weighted sequences (dynamic, 2D versus 3D, and type of 3D sequence). From our institutional data, specific postgadolinium T1-weighted sequences were helpful in identifying a surgical lesion as follows: dynamic contrast-enhanced, 2/7 (28.6%); 2D FSE, 4/8 (50%); 3D sampling perfection with application-optimized contrasts by using different flip angle evolution (SPACE), 5/6 (83.3%); and 3D MPRAGE, 8/11 (72.7%). The literature review identified Cushing adenomas in 31/33 (93.9%) patients on 7T.CONCLUSIONS: 7T MR imaging for pituitary lesion localization in Cushing disease is a new technique with imaging protocols that vary widely. Further comparative research is needed to identify the optimal imaging technique as well as assess the benefit of 7T over lower-field-strength MR imaging.DCEdynamic contrast-enhancedSPACEsampling perfection with application-optimized contrasts by using different flip angle evolutionVIBEvolumetric interpolated brain examination