Is MRI follow-up relevant in patients with GH-secreting pituitary adenomas primarily treated and responsive to long-acting somatostatin analogues (SMSa)?

Abstract

OBJECTIVE:

Primary SMSa treatment can be associated with hormonal control and tumor shrinkage in patients with GH-secreting pituitary adenomas. The aim of this study was to evaluate whether regular MRI follow-up was necessary in patients with acromegaly-treated and responsive to first-generation long-acting SMSa.

PATIENTS AND METHODS:

In this retrospective monocentric study we included patients with GH/IGF-1 hypersecretion and pituitary adenomas with normal visual field, primarily treated with first-generation long-acting SMSa between 1995 and 2015 and regularly monitored (clinical evaluation, GH/IGF-1 levels and pituitary MRI) for at least 3 years.

RESULTS:

We included 83 patients (32 men and 51 women, mean age at diagnosis 50 ± 12 years) with mean GH = 19.3 ± 25.6 ng/mL, IGF-1 = 284 ± 110% ULN and pituitary adenoma height = 12.9 ± 4.7 mm. Mean follow-up was 8.9 ± 4.9 years in 36 controlled patients and 2.0 ± 1.6 years in 47 partial responders to SMSa alone. No significant increase in pituitary adenoma height was observed. Pituitary adenoma height decreased significantly in controlled patients (diagnosis: 11.9 ± 4.8 mm, SMSa: 9.6 ± 3.3 mm, P < 0.001), and in partially responders (diagnosis: 13.6 ± 4.5 mm, SMSa: 11.5 ± 4.5 mm, P < 0.001).

CONCLUSION:

During SMSa treatment, no significant increase in GH-secreting adenoma size was observed. Primary SMSa treatment was associated with a significantly decrease in adenoma height in our population. Our cohort data suggest that regular MRI follow-up does not seem relevant in patients with acromegaly who are responsive to SMSa treatment.

• Authors: Naia Grandgeorge, Giovanni Barchetti, Solange Grunenwald, Fabrice Bonneville, Philippe Caron
• Journal: European journal of endocrinology (Eur J Endocrinol) Vol. 182 Issue 1 Pg. 123-130 (Jan 2020) ISSN: 1479-683X [Electronic] England
• PMID: 31705796 (Publication Type: Journal Article)

Chemical References

• Human Growth Hormone
• Somatostatin
• Insulin-Like Growth Factor I

Topics

• Adult
• Female
• Follow-Up Studies
• Growth Hormone-Secreting Pituitary Adenoma (blood, diagnostic imaging, drug therapy)
• Human Growth Hormone (blood)
• Humans
• Insulin-Like Growth Factor I (metabolism)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Retrospective Studies
• Somatostatin (analogs & derivatives, therapeutic use)