Clinicopathological significance of baseline T2-weighted signal intensity in functional pituitary adenomas

Dogansen, Sema Ciftci; Yalin, Gulsah Yenidunya; Tanrikulu, Seher; Tekin, Sakin; Nizam, Nihan; Bılgıç, Bilge; Sencer, Serra; Yarman, Sema

doi:10.1007/s11102-018-0877-3

Cited by 46 publications

(32 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, Heck et al reported that T2-hypointense adenomas had a better hormonal response to presurgically administered somatostatin analogs, suggesting that T2-hypointensity might be a useful pre-operative marker of somatostatin analogs response [13,15]. An expanding body of evidence has led to the view that the presence of T2-hypointensity on sellar MRI predicts a favorable response to somatostatin analogs in GH-secreting pituitary adenomas [8,10,14,19,31,33]. Accordingly, these ndings raise intriguing question about whether T2-hypointense GH-secreting pituitary adenomas could be more amenable to complete resection as compared with T2-hyperintense and T2-isointense adenomas [28].…”

Section: Discussionmentioning

confidence: 99%

“…Acromegaly is a rare disease, characterized by increased release of growth hormone (GH) and, consequently, insulin-like growth factor I (IGF-I) with an incidence of about 3-5/ 1000000/year [6,8]. Endoscopic endonasal transsphenoidal surgery (EETSS) is a cornerstone and the rst line therapy in the management of acromegaly, although postoperative medical treatment with somatostatin analogues (SSA) may be necessary and a variety of established and novel therapeutic options are available [3,24,26,30].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

T2-weighted Magnetic Resonance Imaging as a novel predictor of surgical remission in newly diagnosed acromegaly

Akkaya

Akgün

Durmaz

et al. 2021

Preprint

View full text Add to dashboard Cite

Background Any preoperative diagnostic assessment that can predict the success of the operation in acromegaly will provide a positive impact on overall remission rates. The aim of this study is to present whether signal intensity on T2-weighted Magnetic Resonance Imaging could predict postoperative results in acromegaly patients. Methods We analyzed our surgical results in regard to T2-weighted images in newly diagnosed consecutive 124 patients with acromegaly, operated between 2014 and 2019. The T2-intensity of the pure somatotroph adenomas was correlated with the clinical, radiological, surgical and histopathological characteristics of the acromegaly patients. Results We found a predominance of T2-hyperintensity in our series (45%) and the T2-hypointense pure somatotroph adenomas were detected in only 34% of our patients. Total resection was performed in 72% of newly diagnosed acromegaly patients in this series. Accordingly, total resection was achieved in 69% of the T2-hyperintense group, 77% of the T2-hypointense group and 69% of the T2-isointense group. The surgical remission rates for the T2-hyper-, hypo- and isointense groups were 55%, 80%, and 69%, respectively. The surgical remission rate in the T2-hyperintense group was significantly lower than those of hypo- and isointense groups in newly diagnosed acromegaly patients. Conclusions This study demonstrates a close relationship between the T2 signal intensity and the surgical remission rates in acromegaly. T2 signal intensity seems to be an indicator of the degree of surgical resection completeness in pure somatotroph adenomas. The implications suggest that preoperative T2-intensity may directly predict the probability of post-surgical remission as an important independent factor in patients with newly diagnosed acromegaly.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

T2-weighted Magnetic Resonance Imaging as a novel predictor of surgical remission in newly diagnosed acromegaly

Akkaya

Akgün

Durmaz

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…T2-weighted MRI signal intensity of the adenoma has been shown to correlate with granulation pattern and has also been proven to correlate directly with treatment response to first-generation SRLs (68,69,70,106). If histological classification is not available, particularly if preoperative pharmacological treatment is considered, T2 hypointensity is an indicator of first-generation SRLs efficacy.…”

Section: First-generation Srlsmentioning

confidence: 99%

“…The EM-nomenclature SG and DG has been kept in the present pathological WHO classification (73), although perinuclear pattern and dotlike pattern would be more correct when referring to anti-Cam5.2 staining pattern. The anti-secretory and antitumour effects of first-generation SRLs are most prominent in DG adenomas, while SG adenomas often have blunted response on SRLs or even resistance (67,68,71,74,75,76). In patients with DG adenomas, first-generation SRLs should be considered as preferred pharmacological treatment among the available substances.…”

Section: First-generation Srlsmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Individualised management of acromegaly

Bollerslev

Heck

Olarescu

2019

European Journal of Endocrinology

View full text Add to dashboard Cite

Acromegaly is a rare and challenging disease calling for management in highly specialised multidisciplinary teams (MDTs). Untreated disease has severe morbidity and a clearly increased mortality. Major attainments have been gained over the latest decades, and therefore, the aim of this review is to discuss recent achievements in modern multimodal therapy of acromegaly performed by MDTs, with an emphasis on an individualised, proactive management from the time of diagnosis to long-term outcome. Treatment by surgery is the only potential curative treatment, however, even with modern techniques still with modest cure rates, leaving the patients to often long-term medical treatment. Treatment strategies have changed dramatically in the Western world over recent years, implying a more proactive treatment algorithm often with a shorter or longer pre-surgical treatment period with somatostatin receptor ligands (SRLs). Not all patients will however respond to primary treatment with conventional SRLs and there has recently been a development of potential biomarkers for response that has been implemented in the clinical routine. By today, multimodal treatment can bring every patient in remission, but still almost a third of all patients are undertreated according to large, international registries. On the other hand, it might be a challenge not to over treat thereby bringing the patient into a state of relative or absolute growth hormone deficiency. Clinical series published during the last decade on treatment of patients with acromegaly have indicated a normalisation of mortality, most probably reflecting the proactive and individualised modern treatment. In conclusion, modern, multimodal treatment seems to have normalised mortality, but still the patients suffer from a high multi-organ morbidity and often multipharmacy. Every patient should receive an individualised, proactive treatment in order to improve long-term outcome and to reduce costs for the society.Correspondence should be addressed to J Bollerslev . His special interest is within clinical and translational endocrinology, and in particular, in classical endocrine diseases, such as acromegaly and Cushing's, often studying bone as target tissues for clinical activity. A major topic has been clinical management of acromegaly, and especially searching for biomarkers for responsiveness to medical therapy. Prospectively collected data of newly diagnosed patients with acromegaly has been the background for current studies of individualised, multimodal and transdisciplinary treatment. European Journal of Endocrinology 181:2 R60 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R61 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R63 Review J Bollerslev and others Managing acromegaly https://eje.bioscientifica.com European Journal of Endocrinology 181:2 R64 Review J Bollerslev and others Managing acromegaly https://eje.bioscie...

show abstract

“…Thus, there is a theoretical possibility that selecting only denselygranulated T2-hypointense tumors for SRL pretreatment may uncover major differences in the surgical control rates since the non-responsive tumors would not be included in the general analytical pool. Dogansen et al [40] have recently published a study addressing this point. They reviewed results of SRL treatment on surgical control rates in 78 patients with acromegaly and different T2 images of their pituitary tumors.…”

Section: Cellular Effects Of Srls On Somatotropinomasmentioning

confidence: 99%

Preoperative treatment of growth hormone (GH) producing macroadenomas with somatostatin receptor ligands (SRLs) to improve surgical outcome: a critical analysis

Barkan

Barkan²

2018

Endo Serg

View full text Add to dashboard Cite

Thirty years ago, a hypothesis stating that preoperative shrinkage of growth hormone (GH) producing macroadenomas with somatostatin receptor ligands (SRLs) may improve surgical outcome was put forward. Since then, multiple retrospective, non-randomized studies as well as four contemporary prospective, randomized studies have been performed to evaluate the validity of that hypothesis and are critically reviewed in this manuscript. With the exception of an occasional retrospective study the great preponderance of evidence could not confirm this hypothesis. Similarly, while all prospective studies suggested better surgical outcome for SRL-pretreated tumors 3 months post surgery, the differences in outcomes between pretreated and untreated control patients disappeared after 6–12 months. Thus, preoperative treatment of macrosomatotropinomas with SRLs should not be relied upon as a means to achieve complete tumor removal and cannot be recommended.

show abstract

Clinicopathological significance of baseline T2-weighted signal intensity in functional pituitary adenomas

Abstract: Baseline hypointense somatotroph adenomas show a better response to SSA, whereas hypointensity was related to DA resistance in female prolactinomas.

Cited by 46 publications

References 35 publications

T2-weighted Magnetic Resonance Imaging as a novel predictor of surgical remission in newly diagnosed acromegaly

T2-weighted Magnetic Resonance Imaging as a novel predictor of surgical remission in newly diagnosed acromegaly

MANAGEMENT OF ENDOCRINE DISEASE: Individualised management of acromegaly

Preoperative treatment of growth hormone (GH) producing macroadenomas with somatostatin receptor ligands (SRLs) to improve surgical outcome: a critical analysis

Contact Info

Product

Resources

About