Recommendations for the diagnosis and radiological follow-up of pituitary neuroendocrine tumours

Fajardo‐Montañana, Carmen; Villar, R.; Gómez‐Anson, Beatriz; Brea, Beatriz; Mosqueira, Antonio Jesús; Mollá, Enrique; Enseñat, Joaquín; Riesgo, Pedro; Cardona-Arboniés, Jorge; Hernando, O.

doi:10.1016/j.endien.2021.10.014

Cited by 2 publications

(3 citation statements)

References 115 publications

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“…The following parameters were recorded: maximum transverse (T), craniocaudal (CC) and anteroposterior (AP) diameter of the adenoma, the volume of the adenoma calculated using the ellipsoid formula [volume (mm 3 ) = (T (mm) × CC (mm) × AP (mm) diameters) × π/6], the presence of cavernous sinus invasion according to the Knosp classification [9], the presence or not of chiasmatic compression and the T2-weighted signal. The T2-weighted signal of the adenoma was classified as hypointense, isointense or hyperintense by visual comparison with normal pituitary tissue or the gray matter of the temporal lobe in cases where normal pituitary tissue was not visible [2,10]. To classify heterogeneous pituitary tumors on T2, the most hyperintense part was considered.…”

Section: Methodsmentioning

confidence: 99%

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Clinical Significance of T2-Weighted Sequence Intensity on Magnetic Resonance Imaging in Clinically Non-Functioning Pituitary Adenomas

Iglesias,

Biagetti,

Araujo-Castro

et al. 2023

Exp Clin Endocrinol Diabetes

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Background Little is known about the relationship between signal intensity patterns on T2-weighted magnetic resonance imaging (MRI) in non-functioning pituitary adenomas (NFPAs). Objective In this study, the clinical, hormonal, histological features, and therapeutic responses were evaluated according to the T2 signal intensity in NFPAs. Methods This retrospective and multicenter study included a group of 166 NFPA patients (93 men, 56%, mean age 58.5 ±14.8 yr). Results: Approximately half of the tumors (n=84, 50.6%) were hyperintense, while 34.3% (n=57) and 15.1% (n=25) were iso- and hypointense, respectively. The median maximum tumor diameter of the isointense group [16 (13–25) mm] was significantly lower than that of the hyperintense [23 (16.6–29.7) mm] group (p=0.003). Similarly, the tumor volume of the isointense group [1,523 (618–5,226) mm3] was significantly lower than that of the hyperintense [4,012 (2,506–8,320) mm3] group (p=0.002). Chiasmatic compression occurred less frequently in tumors with isointense signal characteristics (38.6%) compared to tumors with hypointense (68%) and hyperintense (65.5%) signal characteristics (p=0.003). Invasive adenomas (p=0.001) and the degree of cavernous sinus invasion (p<0.001) were more frequent in the hyperintense adenoma group compared to the remaining groups. Plurihormonal tumors and silent lactotroph adenomas were more frequent in the isointense tumor group. Conclusion In conclusion, hyperintensity on T2-weighted MRI in NFPAs is associated with larger and more invasive tumors compared to isointense NFPAs.

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Section: Methodsmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) is considered the reference imaging method in the diagnosis, therapeutic orientation, surgical planning, clinical follow-up, and evaluation of the response to treatment in patients with pituitary adenomas (PAs) [1,2].…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of T2-Weighted Sequence Intensity on Magnetic Resonance Imaging in Clinically Non-Functioning Pituitary Adenomas

Iglesias,

Biagetti,

Araujo-Castro

et al. 2023

Exp Clin Endocrinol Diabetes

View full text Add to dashboard Cite

show abstract

“…Magnetic resonance imaging (MRI) is considered the reference imaging test in the diagnosis, therapeutic orientation, surgical planning, clinical follow-up and evaluation of the response to treatment in patients with pituitary adenomas (PAs) [1,2].…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of T2-weighted Sequence Intensity on Magnetic Resonance Imaging in Non-functioning Pituitary Neuroendocrine Tumors (Nf-pitnets)

Iglesias

2023

Preprint

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Background. Little is known about the relationship between signal intensity patterns on T2-weighted magnetic resonance imaging (MRI) in non-functioning pituitary neuroendocrine tumors (NF-PitNETs). Aims. To evaluate the clinical, hormonal, histological features, and therapeutic responses according to the T2 signal intensity in NF-PitNETs. Patients and Methods. A retrospective and multicenter study was performed. NF-PitNETs were classified according to the T2-weighted MRI into hypointense, isointense and hyperintense adenomas. Results. A group of 166 NF-pitNET patients (93 men, 56%, mean age 58.5 ± 14.8 yr) was studied. Approximately half of the tumors (n=84, 50.6%) were hyperintense, while 34.3% (n=57) and 15.1% (n=25) were iso- and hypointense, respectively. The maximum tumor diameter of the isointense group [16 (13-25) mm] was significantly lower than that of hyperintense [23 (16.6-29.7) mm] group (p=0.003), without significant differences between iso- and hypointensive groups. Similarly, tumor volume of the isointense group [16 (13-25) mm] was significantly lower than that of hyperintense [23 (16.6-29.7) mm] group (p=0.002), without significant differences between iso- and hypointensive groups. Chiasmatic compression was less common in isointense (38.6%) tumors compared to hypointense (68%) and hyperintense (65.5%) tumors (p=0.003). Invasive adenomas (p=0.001) and the degree of cavernous sinus invasion (p<0.001) was more frequent in the hyperintense adenoma group compared to the remaining groups. 116 (69.9%) patients underwent surgery, 32 (19.3%) were followed by active surveillance and 18 (10.8%) were treated with cabergoline as first-line therapy. The percentage of patients with isointense tumors who underwent surgery was significantly lower than that of patients with non-isointense adenomas (59.6% vs 75.2%, p=0.038). Plurihormonal tumors and silent lactotroph adenomas were more frequent in the isointense tumor group, whereas silent corticotropinomas and silent somatotropinomas were more common in the non-isointense tumor group (p=0.02). No significant differences in the type of surgical response between the groups analyzed were found. Conclusion. Hyperintensity on T2-weighted MRI in NF-PitNETs is associated with larger and more invasive tumors compared to isointense adenomas. Non-isointense adenomas (hypo- and hyperintense) were more likely to undergo surgery compared to isointense adenomas. However, the degree of intensity on T2-weighted sequences of the adenoma does not seem to influence the type of therapeutic response in these tumors.

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Recommendations for the diagnosis and radiological follow-up of pituitary neuroendocrine tumours

Cited by 2 publications

References 115 publications

Clinical Significance of T2-Weighted Sequence Intensity on Magnetic Resonance Imaging in Clinically Non-Functioning Pituitary Adenomas

Clinical Significance of T2-Weighted Sequence Intensity on Magnetic Resonance Imaging in Clinically Non-Functioning Pituitary Adenomas

Clinical Significance of T2-weighted Sequence Intensity on Magnetic Resonance Imaging in Non-functioning Pituitary Neuroendocrine Tumors (Nf-pitnets)

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