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

Presentation Number: SUN 453
Date of Presentation: April 2nd, 2017

Amit Tirosh*1, Georgios Papadakis2, Prashant Chittiboina3, Charalampos Lyssikatos4, Elena Belyavskaya5, Margaret Farmar Keil5, Maya Beth Lodish4 and Constantine A. Stratakis4
1National Institutes of Health, Bethesda, MD, 2National Institutes of Health, 3National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), Bethesda, MD, 4Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, 5Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH)., Bethesda, MD

Abstract

Objective

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.

 

Methods

A retrospective cohort study 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.

 

Results

Twenty seven patients (11 females) were included, median age 21.0 years (Inter quartile range 29 years, range 3-61 years). Patients harboring adenomas with a volume <2000 mm3 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.

 

Conclusions

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

 

Nothing to Disclose: AT, GP, PC, CL, EB, MFK, MBL, CAS