T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly
Language English Country Great Britain, England Media print-electronic
Document type Clinical Trial, Journal Article, Multicenter Study
PubMed
27649724
DOI
10.1530/erc-16-0356
PII: ERC-16-0356
Knihovny.cz E-resources
- Keywords
- MRI, acromegaly, predictor, somatostatin analogs, treatment response,
- MeSH
- Growth Hormone-Secreting Pituitary Adenoma diagnosis drug therapy pathology MeSH
- Adenoma diagnosis drug therapy metabolism pathology MeSH
- Acromegaly diagnosis drug therapy metabolism pathology MeSH
- Insulin-Like Growth Factor I metabolism MeSH
- Middle Aged MeSH
- Humans MeSH
- Human Growth Hormone metabolism MeSH
- Magnetic Resonance Imaging * methods MeSH
- Octreotide therapeutic use MeSH
- Prognosis MeSH
- Somatostatin analogs & derivatives MeSH
- Tumor Burden drug effects MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Clinical Trial MeSH
- Multicenter Study MeSH
- Names of Substances
- Insulin-Like Growth Factor I MeSH
- Human Growth Hormone MeSH
- Octreotide MeSH
- Somatostatin MeSH
GH-secreting pituitary adenomas can be hypo-, iso- or hyper-intense on T2-weighted MRI sequences. We conducted the current multicenter study in a large population of patients with acromegaly to analyze the relationship between T2-weighted signal intensity on diagnostic MRI and hormonal and tumoral responses to somatostatin analogs (SSA) as primary monotherapy. Acromegaly patients receiving primary SSA for at least 3 months were included in the study. Hormonal, clinical and general MRI assessments were performed and assessed centrally. We included 120 patients with acromegaly. At diagnosis, 84, 17 and 19 tumors were T2-hypo-, iso- and hyper-intense, respectively. SSA treatment duration, cumulative and mean monthly doses were similar in the three groups. Patients with T2-hypo-intense adenomas had median SSA-induced decreases in GH and IGF-1 of 88% and 59% respectively, which were significantly greater than the decreases observed in the T2-iso- and hyper-intense groups (P < 0.001). Tumor shrinkage on SSA was also significantly greater in the T2-hypo-intense group (38%) compared with the T2-iso- and hyper-intense groups (8% and 3%, respectively; P < 0.0001). The response to SSA correlated with the calculated T2 intensity: the lower the T2-weighted intensity, the greater the decrease in random GH (P < 0.0001, r = 0.22), IGF-1 (P < 0.0001, r = 0.14) and adenoma volume (P < 0.0001, r = 0.33). The T2-weighted signal intensity of GH-secreting adenomas at diagnosis correlates with hormone reduction and tumor shrinkage in response to primary SSA treatment in acromegaly. This study supports its use as a generally available predictive tool at diagnosis that could help to guide subsequent treatment choices in acromegaly.
Center of Endocrinology and MetabolismBamberg Germany
Centre Pierre et Marie CurieAlgiers Algeria
Charles UniversityPrague Czech Republic
CHU de Liège University of LiègeLiège Belgium
CHU Jean MinjozBesancon France
CHU StrasbourgStrasbourg France
Erasmus University Medical Center RotterdamRotterdam Netherlands
Faculty of MedicineErciyes University Kayseri Turkey
Hospital Sant PauCentro de Investigación Biomédica en Red de Enfermedades Raras Barcelona Spain
Hospital Universitario Gregorio MarañonMadrid Spain
Kazan State Medical AcademyKazan Russia
Moscow Regional Research and Clinical InstituteRussia
Universitätsklinikum ErlangenErlangen Germany
Université Catholique de LouvainBrussels Belgium
References provided by Crossref.org
Acromegaly at diagnosis in 3173 patients from the Liège Acromegaly Survey (LAS) Database
