3D Volumetric Measurements of GH Secreting Adenomas Correlate with Baseline Pituitary Function, Initial Surgery Success Rate, and Disease Control

Abstract

There is scarce data on the clinical utility of volume measurement for growth hormone (GH)-secreting pituitary adenomas. The current study objective was to assess the association between pituitary adenoma volumes and baseline endocrine evaluation, initial surgical success rate, and disease control among patients with acromegaly. A retrospective cohort study was conducted at a clinical research center including patients with acromegaly due to GH-secreting pituitary adenomas. Baseline hormonal evaluation and adenoma characteristics according to MRI were collected. Volumetric measurements of pituitary adenomas were performed using a semi-automated lesion segmentation and tumor-volume assessment tools. Rates of post-operative medical treatment, radiation therapy, and re-operation were gathered from the patients' medical records. Twenty seven patients (11 females) were included, median age 21.0 years (interquartile range 29 years, range 3-61 years). Patients harboring adenomas with a volume <2 000 mm had higher chance to achieve disease remission [94.1% (n=16) vs. 50.0% (n=4), p<0.05]. Adenoma volumes positively correlated with baseline plasma GH levels before and after oral glucose administration, and with plasma IGF-I and PRL levels. Adenoma volume had negative correlation with morning plasma cortisol levels. Finally, patients harboring larger adenomas required 2nd surgery and/or medical treatment more often compared with subjects with smaller adenomas. Accurate 3D volume measurement of GH-secreting pituitary adenomas may be used for the prediction of initial surgery success and for disease control rates among patients with a GH-secreting pituitary adenomas and performs better than standard size assessments.

Complications and Comorbidities of Acromegaly—Retrospective Study in Polish Center

“…In Tirosh et al. study ( 25 ) an association between tumor volume and hypogonadism was determined, more pronounced in males, which was not obtained in our study. In that study also an association between size of tumor > 10 mm before the operation and the need for re-operation was observed.…”

“…The prevalence of diabetes in acromegaly patients is 12% to 53% ( 17 , 19 , 30 , 33 , 34 ). We observed diabetes in 33% of the cases and prediabetes in 34%, which is much higher than in the general Polish population (6.97%) ( 25 ). In Warncke’s study, it has been reported that in acromegaly diabetes affects younger patients (50.1 years) than in the general population (59 years) ( 35 ).…”

“…Similarly, such correlations were observed for acromegaly patients before surgery ( 24 ). Adenoma measurements correlated positively with GH levels, but not with IGF-I levels in Tirosh et al ( 25 ). and Evran et al ( 26 ).…”

Adrenal morphology and associated comorbidities in congenital adrenal hyperplasia

“…This tracing included any bulges of the contour caused by nodules or masses in the adrenal periphery. The adrenal volume was calculated from the sum of each axial slice area …”

“…This tracing included any bulges of the contour caused by nodules or masses in the adrenal periphery. The adrenal volume was calculated from the sum of each axial slice area 19,20. Adrenal morphology was categorized as normal, atrophy, hyperplasia with or without nodules (<5mm), adrenocortical adenomas (≥5mm), myelolipoma or other.…”