Modern imaging of pituitary adenomas

Waiel A Bashari; Russell Senanayake; Antía Fernández-Pombo; Daniel Gillett; Olympia Koulouri; Andrew S Powlson; Tomasz Matys; Daniel Scoffings; Heok Cheow; Iosif Mendichovszky; Mark Gurnell

doi:10.1016/j.beem.2019.05.002

Modern imaging of pituitary adenomas

Best Pract Res Clin Endocrinol Metab. 2019 Apr;33(2):101278. doi: 10.1016/j.beem.2019.05.002. Epub 2019 May 28.

Affiliations

¹ Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
² Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK; Division of Endocrinology and Nutrition, University Clinical Hospital of Santiago de Compostela, Spain.
³ Cambridge Endocrine Molecular Imaging Group, Department of Nuclear Medicine, University of Cambridge, National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
⁴ Cambridge Endocrine Molecular Imaging Group, Department of Radiology, University of Cambridge, National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
⁵ Cambridge Endocrine Molecular Imaging Group, Department of Nuclear Medicine, University of Cambridge, National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK; Cambridge Endocrine Molecular Imaging Group, Department of Radiology, University of Cambridge, National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK.
⁶ Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Hills Road, Cambridge, CB2 0QQ, UK. Electronic address: mg299@medschl.cam.ac.uk.

PMID: 31208872
DOI: 10.1016/j.beem.2019.05.002

Abstract

Decision-making in pituitary disease is critically dependent on high quality imaging of the sella and parasellar region. Magnetic resonance imaging (MRI) is the investigation of choice and, for the majority of patients, combined T1 and T2 weighted sequences provide the information required to allow surgery, radiotherapy (RT) and/or medical therapy to be planned and long-term outcomes to be monitored. However, in some cases standard clinical MR sequences are indeterminate and additional information is needed to help inform the choice of therapy for a pituitary adenoma (PA). This article reviews current recommendations for imaging of PA, examines the potential added value that alternative MR sequences and/or CT can offer, and considers how the use of functional/molecular imaging might allow definitive treatment to be recommended for a subset of patients who would otherwise be deemed unsuitable for (further) surgery and/or RT.

Keywords: CT; MRI; PET; functional imaging; molecular imaging; pituitary.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Adenoma / diagnosis*
Adenoma / pathology
Adenoma / therapy
Diagnosis, Differential
Diagnostic Imaging / methods
Diagnostic Imaging / trends*
Humans
Magnetic Resonance Imaging / methods
Neuroimaging / methods
Neuroimaging / trends
Pituitary Diseases / diagnosis
Pituitary Neoplasms / diagnosis*
Pituitary Neoplasms / pathology
Pituitary Neoplasms / therapy