June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
MR imaging of the optic nerve and chiasm at 7 Tesla improves lesion detection for Neuro-Ophthalmic conditions compared to conventional clinical field strength
Author Affiliations & Notes
  • Lorna Grech Fonk
    Ophthalmology, Leiden University Medical Centre , Leiden, Netherlands
    Radiology, C.J. Gorter Center for high field MRI, Leiden University Medical Center, Leiden, Netherlands
  • Marco Verstegen
    Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
  • Wouter Teeuwisse
    Radiology, C.J. Gorter Center for high field MRI, Leiden University Medical Center, Leiden, Netherlands
  • Teresa Ferreira
    Radiology, C.J. Gorter Center for high field MRI, Leiden University Medical Center, Leiden, Netherlands
  • Irene Notting
    Ophthalmology, Leiden University Medical Centre , Leiden, Netherlands
  • Wouter van Furth
    Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
  • Alberto Pereira
    Endocrinology, Leiden University Medical Center, Leiden, Netherlands
  • Gregorius P M Luyten
    Ophthalmology, Leiden University Medical Centre , Leiden, Netherlands
  • Andrew Webb
    Radiology, C.J. Gorter Center for high field MRI, Leiden University Medical Center, Leiden, Netherlands
  • Jan-Willem Beenakker
    Ophthalmology, Leiden University Medical Centre , Leiden, Netherlands
    Radiology, C.J. Gorter Center for high field MRI, Leiden University Medical Center, Leiden, Netherlands
  • Footnotes
    Commercial Relationships   Lorna Grech Fonk, None; Marco Verstegen, None; Wouter Teeuwisse, None; Teresa Ferreira, None; Irene Notting, None; Wouter van Furth, None; Alberto Pereira, None; Gregorius Luyten, None; Andrew Webb, None; Jan-Willem Beenakker, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 3318. doi:
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      Lorna Grech Fonk, Marco Verstegen, Wouter Teeuwisse, Teresa Ferreira, Irene Notting, Wouter van Furth, Alberto Pereira, Gregorius P M Luyten, Andrew Webb, Jan-Willem Beenakker; MR imaging of the optic nerve and chiasm at 7 Tesla improves lesion detection for Neuro-Ophthalmic conditions compared to conventional clinical field strength. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3318.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Growth of a pituitary adenoma impinges on the optic chiasm causing visual field (VF) defects to varying degrees. Surgical removal of the tumor often restores most of the visual function. However, the VF defects occasionally reoccur years after successful treatment. MRI is currently an important tool for diagnosis and therapy planning. Conventional clinical scanners operate at a field strength of 3 Tesla (T). However, scanning patients at the ultra-high field strength of 7T has the potential to acquire higher resolution images than at 3T. In this study, we evaluate the additional value of 7T MRI in the diagnosis and treatment of pituitary macro-adenomas.

Methods : Nine controls and seven patients were scanned on a commercial Philips whole body 7T MR system. 3D T1-weighted gradient-echo with isotropic resolution (0.7mm3); and 2D T2-weighted spin echo (0.45x0.45x1.0mm3) were acquired. For comparison, standard clinical protocol was run on a 3T Philips system.

Results : The 7T scan protocol gave reproducible image quality for each of the patients scanned, with image quality superior to 3T. In three patients the 7T MRI revealed important clinical information that was not visible at 3T. In two patients, a small lesion was noted in the optic nerve (ON) at 7T (Figure 1) which was not visible in the 3T images. The location of the lesions corresponded to the VF defects. This was an important confirmation for the ophthalmologists to tailor treatment strategy. In a second patient, the thinner (1mm vs 3mm) slices that could be acquired at 7T due to its superior signal-to-noise showed tumor contact with the chiasm (Figure 2) whilst at 3T this was not visible. This was key for the neurosurgeon to plan the best intervention.

Conclusions : This study shows that 7Tesla MRI provides direct clinical opportunities for the treatment of patients with pituitary tumors and other neuro-ophthalmic conditions.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

VF defect recurrence 4 years post treatment. Hyperintense lesions in ON clearly visible and not visible on 3T. Location of lesions corresponds with VF defect

VF defect recurrence 4 years post treatment. Hyperintense lesions in ON clearly visible and not visible on 3T. Location of lesions corresponds with VF defect

 

T1 (top) T2 (lower) pre-op MRI showing large pituitary macro-adenoma. 7T image shows contact between tumor and chiasm, this is not apparent on 3T

T1 (top) T2 (lower) pre-op MRI showing large pituitary macro-adenoma. 7T image shows contact between tumor and chiasm, this is not apparent on 3T

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