Intensity of pituitary adenoma on T2‐weighted magnetic resonance imaging predicts the response to octreotide treatment in newly diagnosed acromegaly

Abstract

In patients with acromegaly, T2 signal intensity at diagnosis correlates with histological features and predicts biochemical outcome of first-line SA treatment.

T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly

“…These results are in keeping with those of Heck and coworkers, who showed median IGF-1 reductions of 51% for T2-hypo-intense, 36% for T2-iso-intense and 13% for T2-hyper-intense adenomas, respectively, and a higher IGF-1 control rate in T2-hypo-intense patients (Heck et al 2012). In terms of control, however, in our study T2-hypo-intense adenomas had IGF-1 normalization in a quarter (21/84) of patients, whereas composite GH/IGF-1 control was achieved in 14/84 patients (16.6%).…”

“…These results confirm and build upon previous studies on T2-weighted MRI signal intensity in acromegaly. As shown previously, T2-hypo-intensity is more frequent in smaller adenomas that are less invasive (Hagiwara et al 2003, Heck et al 2012, Potorac et al 2015. Also, T2-hyper-intensity is more frequent in sparsely granulated pituitary adenomas (Hagiwara et al 2003, Heck et al 2012.…”

“…As shown previously, T2-hypo-intensity is more frequent in smaller adenomas that are less invasive (Hagiwara et al 2003, Heck et al 2012, Potorac et al 2015. Also, T2-hyper-intensity is more frequent in sparsely granulated pituitary adenomas (Hagiwara et al 2003, Heck et al 2012. As these characteristics are related to easier control of acromegaly, this has spurred interest in the relationship between T2 intensity and response to SSA therapy.…”

“…Interestingly, Puig-Domingo and coworkers previously noted that T2-hypo-intense post-operative adenoma residues (n = 62) were more sensitive to subsequent SSA therapy (Puig-Domingo et al 2010). Similarly, Heck and coworkers reported that T2-hypo-intense adenomas had a better hormonal response to pre-operatively administered SSA, suggesting that T2-hypo-intensity might be a useful pre-operative marker of SSA response (Heck et al 2012, Heck et al 2015. Recent guidelines for acromegaly management have also noted the potential utility of using T2 intensity to optimize patient management (Katznelson et al 2014).…”

Análise da expressão da filamina A nos tumores hipofisários e suas implicações clínicas e terapêuticas

“…Dentre os fatores relacionados à resistência, vale ressaltar parâmetros clínicos (gênero masculino (79) , idade mais jovem (80) , maior tamanho e invasividade tumoral (81,82) , hipersinal nas aquisições em T2 na ressonância selar (83) ) e histopatológicos (menor expressão SSTR2 (73,(84)(85)(86) , menor relação SSTR2/SSTR5 (84) e padrão esparsamente granulado (87) ).…”