Added value of dynamic contrast-enhanced magnetic resonance imaging in predicting response to somatostatin analogs in patients with acromegaly

AIM: To investigate the added value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) sequences in predicting somatostatin analog (SSA) responses in patients with acromegaly. MATERIAL AND METHODS: This study included 55 active acromegaly patients with macroadenoma. Mean and maximum signal intensities were measured using region of interests in T2-weighted (T2W) and DCE-MRI sequences. Semi-quantitative values indicating relative signal intensity ratios and contrast-enhanced kinetics were obtained. Bivariate and multivariate analyses were used 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, x2(3)=23.278, p < 0.0001: age (odds ratio [OR]=1.08), hypointensity of adenomas 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, and negative 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's age, and ER2 < submax parameter from DCE-MRI sequences might be used to more accurately predict SSA responses.