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<meta name="HW.identifier" content="/ajnr/early/2024/12/20/ajnr.A8439.atom" />
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<meta name="DC.Title" content="Noncontrast MRI Surveillance of Craniopharyngiomas Using a Balanced Steady-state Free Precession (bSSFP) Sequence" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8439" />
<meta name="DC.Date" content="2024-12-20" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2025 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Contrast-enhanced MRI (CEMRI) is a commonly used imaging technique for craniopharyngioma surveillance; however, it carries risks such as allergic reaction and gadolinium deposition. This study evaluates the efficacy of non contrast–enhanced MRI (NCMRI) with a balanced steady-state free precession (bSSFP) sequence compared with CEMRI T1-weighted imaging for craniopharyngioma surveillance.

MATERIALS AND METHODS: Twenty-nine patients with craniopharyngioma (16 females/13 males, mean age =21.5 ± 4.3 years) with CEMRIs, including a bSSFP sequence, were evaluated. For each patient, 2 blinded neuroradiologists compared the dimensions of residual craniopharyngioma on non-contrast– and contrast-enhanced sequences. Tumor volume and solid/cystic component measurements were evaluated by using paired t -tests. Diagnostic confidence levels for non-contrast– and contrast-enhanced evaluations were measured by using a 3-point scale (2 = confident, 1 = adequate, 0 = unsure). Analyses of tumor involvement of cranial nerves (CNs) and adjacent vasculature and diagnostic confidence were performed by using Fisher exact and chi-square tests.

RESULTS: No significant difference was observed between residual tumor volumes in both studies (18.86 ± 21.67 cm3 versus 17.64 ± 23.85 cm3, P = .55) and measurements of dominant solid component volume, number of cystic components, and largest cystic component volume (2.71 ± 3.47 cm3 versus 3.95 ± 5.51 cm3, P = .10; 2.5 ± 1.5 versus 2.9 ± 1.5, P = .10; 7.61 ± 13.41 versus 6.84 ± 13.37 cm3, P = .22, respectively). Tumor involvement of CNs II ( P = .64), III ( P = .42), and adjacent vasculature ( P = .05) showed no significant differences in detection. Diagnostic confidence was comparable in evaluating CN II, vascular structures, and third ventricle ( P &gt; .05) involvement. Higher levels of confidence were observed with bSSFP sequences for the detection of CN III involvement ( P = .0001) and with contrast-enhanced T1-weighted imaging for cavernous sinus involvement ( P = .02).

CONCLUSIONS: NCMRI techniques by using a bSSFP sequence provide similar characterization of craniopharyngiomas as contrast-enhanced techniques.

ACA
:   anterior cerebral artery
bSSFP
:   balanced steady-state free precession
CEMRI
:   contrast-enhanced MRI
ce-T1W
:   contrast-enhanced T1-weighted imaging
CN
:   cranial nerve
NCMRI
:   non-contrast–enhanced MRI
TR
:   total resection" />
<meta name="DC.Contributor" content="Kelly Trinh" />
<meta name="DC.Contributor" content="Michael Tang" />
<meta name="DC.Contributor" content="Claire White-Dzuro" />
<meta name="DC.Contributor" content="Min Lang" />
<meta name="DC.Contributor" content="Karen Buch" />
<meta name="DC.Contributor" content="Sandra Rincon" />
<meta name="article:published_time" content="2025-12-19" />
<meta name="article:section" content="BRAIN TUMOR IMAGING" />
<meta name="citation_title" content="Noncontrast MRI Surveillance of Craniopharyngiomas Using a Balanced Steady-state Free Precession (bSSFP) Sequence" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Contrast-enhanced MRI (CEMRI) is a commonly used imaging technique for craniopharyngioma surveillance; however, it carries risks such as allergic reaction and gadolinium deposition. This study evaluates the efficacy of non contrast–enhanced MRI (NCMRI) with a balanced steady-state free precession (bSSFP) sequence compared with CEMRI T1-weighted imaging for craniopharyngioma surveillance.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;Twenty-nine patients with craniopharyngioma (16 females/13 males, mean age =21.5 ± 4.3 years) with CEMRIs, including a bSSFP sequence, were evaluated. For each patient, 2 blinded neuroradiologists compared the dimensions of residual craniopharyngioma on non-contrast– and contrast-enhanced sequences. Tumor volume and solid/cystic component measurements were evaluated by using paired &lt;i&gt;t&lt;/i&gt;-tests. Diagnostic confidence levels for non-contrast– and contrast-enhanced evaluations were measured by using a 3-point scale (2 = confident, 1 = adequate, 0 = unsure). Analyses of tumor involvement of cranial nerves (CNs) and adjacent vasculature and diagnostic confidence were performed by using Fisher exact and chi-square tests.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;No significant difference was observed between residual tumor volumes in both studies (18.86 ± 21.67 cm&lt;sup&gt;3&lt;/sup&gt; versus 17.64 ± 23.85 cm&lt;sup&gt;3&lt;/sup&gt;, &lt;i&gt;P&lt;/i&gt; = .55) and measurements of dominant solid component volume, number of cystic components, and largest cystic component volume (2.71 ± 3.47 cm&lt;sup&gt;3&lt;/sup&gt; versus 3.95 ± 5.51 cm&lt;sup&gt;3&lt;/sup&gt;, &lt;i&gt;P&lt;/i&gt; = .10; 2.5 ± 1.5 versus 2.9 ± 1.5, &lt;i&gt;P&lt;/i&gt; = .10; 7.61 ± 13.41 versus 6.84 ± 13.37 cm&lt;sup&gt;3&lt;/sup&gt;, &lt;i&gt;P&lt;/i&gt; = .22, respectively). Tumor involvement of CNs II (&lt;i&gt;P&lt;/i&gt; = .64), III (&lt;i&gt;P&lt;/i&gt; = .42), and adjacent vasculature (&lt;i&gt;P&lt;/i&gt; = .05) showed no significant differences in detection. Diagnostic confidence was comparable in evaluating CN II, vascular structures, and third ventricle (&lt;i&gt;P&lt;/i&gt; &amp;gt; .05) involvement. Higher levels of confidence were observed with bSSFP sequences for the detection of CN III involvement (&lt;i&gt;P&lt;/i&gt; = .0001) and with contrast-enhanced T1-weighted imaging for cavernous sinus involvement (&lt;i&gt;P&lt;/i&gt; = .02).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;NCMRI techniques by using a bSSFP sequence provide similar characterization of craniopharyngiomas as contrast-enhanced techniques.&lt;/p&gt;" />
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<meta name="twitter:title" content="Noncontrast MRI Surveillance of Craniopharyngiomas Using a Balanced Steady-state Free Precession (bSSFP) Sequence" />
<meta name="twitter:card" content="summary" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Contrast-enhanced MRI (CEMRI) is a commonly used imaging technique for craniopharyngioma surveillance; however, it carries risks such as allergic reaction and gadolinium deposition. This study evaluates the efficacy of non contrast–enhanced MRI (NCMRI) with a balanced steady-state free precession (bSSFP) sequence compared with CEMRI T1-weighted imaging for craniopharyngioma surveillance.

MATERIALS AND METHODS: Twenty-nine patients with craniopharyngioma (16 females/13 males, mean age =21.5 ± 4.3 years) with CEMRIs, including a bSSFP sequence, were evaluated. For each patient, 2 blinded neuroradiologists compared the dimensions of residual craniopharyngioma on non-contrast– and contrast-enhanced sequences. Tumor volume and solid/cystic component measurements were evaluated by using paired t -tests. Diagnostic confidence levels for non-contrast– and contrast-enhanced evaluations were measured by using a 3-point scale (2 = confident, 1 = adequate, 0 = unsure). Analyses of tumor involvement of cranial nerves (CNs) and adjacent vasculature and diagnostic confidence were performed by using Fisher exact and chi-square tests.

RESULTS: No significant difference was observed between residual tumor volumes in both studies (18.86 ± 21.67 cm3 versus 17.64 ± 23.85 cm3, P = .55) and measurements of dominant solid component volume, number of cystic components, and largest cystic component volume (2.71 ± 3.47 cm3 versus 3.95 ± 5.51 cm3, P = .10; 2.5 ± 1.5 versus 2.9 ± 1.5, P = .10; 7.61 ± 13.41 versus 6.84 ± 13.37 cm3, P = .22, respectively). Tumor involvement of CNs II ( P = .64), III ( P = .42), and adjacent vasculature ( P = .05) showed no significant differences in detection. Diagnostic confidence was comparable in evaluating CN II, vascular structures, and third ventricle ( P &gt; .05) involvement. Higher levels of confidence were observed with bSSFP sequences for the detection of CN III involvement ( P = .0001) and with contrast-enhanced T1-weighted imaging for cavernous sinus involvement ( P = .02).

CONCLUSIONS: NCMRI techniques by using a bSSFP sequence provide similar characterization of craniopharyngiomas as contrast-enhanced techniques.

ACA
:   anterior cerebral artery
bSSFP
:   balanced steady-state free precession
CEMRI
:   contrast-enhanced MRI
ce-T1W
:   contrast-enhanced T1-weighted imaging
CN
:   cranial nerve
NCMRI
:   non-contrast–enhanced MRI
TR
:   total resection" />
<meta name="og-title" property="og:title" content="Noncontrast MRI Surveillance of Craniopharyngiomas Using a Balanced Steady-state Free Precession (bSSFP) Sequence" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/early/2024/12/20/ajnr.A8439" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Contrast-enhanced MRI (CEMRI) is a commonly used imaging technique for craniopharyngioma surveillance; however, it carries risks such as allergic reaction and gadolinium deposition. This study evaluates the efficacy of non contrast–enhanced MRI (NCMRI) with a balanced steady-state free precession (bSSFP) sequence compared with CEMRI T1-weighted imaging for craniopharyngioma surveillance.

MATERIALS AND METHODS: Twenty-nine patients with craniopharyngioma (16 females/13 males, mean age =21.5 ± 4.3 years) with CEMRIs, including a bSSFP sequence, were evaluated. For each patient, 2 blinded neuroradiologists compared the dimensions of residual craniopharyngioma on non-contrast– and contrast-enhanced sequences. Tumor volume and solid/cystic component measurements were evaluated by using paired t -tests. Diagnostic confidence levels for non-contrast– and contrast-enhanced evaluations were measured by using a 3-point scale (2 = confident, 1 = adequate, 0 = unsure). Analyses of tumor involvement of cranial nerves (CNs) and adjacent vasculature and diagnostic confidence were performed by using Fisher exact and chi-square tests.

RESULTS: No significant difference was observed between residual tumor volumes in both studies (18.86 ± 21.67 cm3 versus 17.64 ± 23.85 cm3, P = .55) and measurements of dominant solid component volume, number of cystic components, and largest cystic component volume (2.71 ± 3.47 cm3 versus 3.95 ± 5.51 cm3, P = .10; 2.5 ± 1.5 versus 2.9 ± 1.5, P = .10; 7.61 ± 13.41 versus 6.84 ± 13.37 cm3, P = .22, respectively). Tumor involvement of CNs II ( P = .64), III ( P = .42), and adjacent vasculature ( P = .05) showed no significant differences in detection. Diagnostic confidence was comparable in evaluating CN II, vascular structures, and third ventricle ( P &gt; .05) involvement. Higher levels of confidence were observed with bSSFP sequences for the detection of CN III involvement ( P = .0001) and with contrast-enhanced T1-weighted imaging for cavernous sinus involvement ( P = .02).

CONCLUSIONS: NCMRI techniques by using a bSSFP sequence provide similar characterization of craniopharyngiomas as contrast-enhanced techniques.

ACA
:   anterior cerebral artery
bSSFP
:   balanced steady-state free precession
CEMRI
:   contrast-enhanced MRI
ce-T1W
:   contrast-enhanced T1-weighted imaging
CN
:   cranial nerve
NCMRI
:   non-contrast–enhanced MRI
TR
:   total resection" />
<meta name="og-type" property="og:type" content="article" />
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<div id="hw-article-author-popups-top-node-112440--8985686027" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Kelly Trinh </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Texas Tech University Health Sciences Center (K.T.), Lubbock, Texas</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Kelly%2BTrinh%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Trinh%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AKelly%2BTrinh%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Michael Tang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>School of Public Health (M.T.), Boston University, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Michael%2BTang%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tang%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AMichael%2BTang%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Claire White-Dzuro </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Vanderbilt University School of Medicine (C.W.-D.), Nashville, Tennessee</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Claire%2BWhite-Dzuro%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=White-Dzuro%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AClaire%2BWhite-Dzuro%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Min Lang </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Harvard Medical School (M.L., K.B., S.R.), Boston, Massachusetts</div><div class='author-affiliation'><span class='nlm-sup'>e</span>Massachusetts General Hospital (M.L., K.B., S.R.), Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Min%2BLang%2B" target="_blank" class="" data-icon-position="" 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class='author-affiliation'><span class='nlm-sup'>e</span>Massachusetts General Hospital (M.L., K.B., S.R.), Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Karen%2BBuch%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Buch%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AKaren%2BBuch%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9579-8921" target="_blank" class="" data-icon-position="" 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div xmlns:xhtml="http://www.w3.org/1999/xhtml" class="contributors"><ol class="contributor-list" id="contrib-group-1"><li class="contributor" id="contrib-1"><span class="name">Kelly Trinh</span><a id="xref-aff-1-1" class="xref-aff" href="#aff-1">a</a>, </li><li class="contributor" id="contrib-2"><span class="name">Michael Tang</span><a id="xref-aff-2-1" class="xref-aff" href="#aff-2">b</a>, </li><li class="contributor" id="contrib-3"><span class="name">Claire White-Dzuro</span><a id="xref-aff-3-1" class="xref-aff" href="#aff-3">c</a>, </li><li class="contributor" id="contrib-4"><span class="name">Min Lang</span><a id="xref-aff-4-1" class="xref-aff" href="#aff-4">d</a><span class="xref-sep">,</span><a id="xref-aff-5-1" class="xref-aff" href="#aff-5">e</a>, </li><li class="contributor" id="contrib-5"><span class="name">Karen Buch</span><a id="xref-aff-4-2" class="xref-aff" href="#aff-4">d</a><span class="xref-sep">,</span><a id="xref-aff-5-2" class="xref-aff" href="#aff-5">e</a> and </li><li class="last" id="contrib-6"><span class="name">Sandra Rincon</span><a id="xref-aff-4-3" class="xref-aff" href="#aff-4">d</a><span class="xref-sep">,</span><a id="xref-aff-5-3" class="xref-aff" href="#aff-5">e</a></li></ol><ol class="affiliation-list"><li class="aff"><a id="aff-1" name="aff-1"></a><address><sup>a</sup>From the Texas Tech University Health Sciences Center (K.T.), Lubbock, Texas</address></li><li class="aff"><a id="aff-2" name="aff-2"></a><address><sup>b</sup>School of Public Health (M.T.), Boston University, Boston, Massachusetts</address></li><li class="aff"><a id="aff-3" name="aff-3"></a><address><sup>c</sup>Vanderbilt University School of Medicine (C.W.-D.), Nashville, Tennessee</address></li><li class="aff"><a id="aff-4" name="aff-4"></a><address><sup>d</sup>Harvard Medical School (M.L., K.B., S.R.), Boston, Massachusetts</address></li><li class="aff"><a id="aff-5" name="aff-5"></a><address><sup>e</sup>Massachusetts General Hospital (M.L., K.B., S.R.), Boston, Massachusetts</address></li></ol><ol class="corresp-list"><li class="corresp" id="corresp-1">Please address correspondence to Sandra Rincon, MD, <span class="addr-line">Division of Neuroradiology, Department of Radiology, Massachusetts General Hospital, 55 Fruit St, Boston, MA</span>; e-mail: <span class="em-link"><span class="em-addr">srincon{at}mgh.harvard.edu</span></span></li></ol></div></div><a href="http://ajnr-stage2.stage.highwire.org/content/early/2024/12/20/ajnr.A8439.full" class="hw-link hw-link-article-full-text" data-icon-position="" data-hide-link-title="0">View Full Text</a></div>  </div>

  
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