Post-operative imaging assessment of non-functioning pituitary adenomas

Kunal S. Patel, Sanjay Dhawan, Renzhi Wang, Bob S. Carter, James Y. Chen, Clark C. Chen

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Non-functioning pituitary adenomas (NFAs) are the most common pituitary tumors. There is significant variability in clinical practice in terms of post-operative imaging evaluation. The objective of this manuscript is to provide an exhaustive review of published articles pertaining to the post-operative imaging evaluation of NFAs. Methods: The MEDLINE database was queried for studies investigating imaging for the post-operative evaluation of pituitary adenomas. From an initial search of 5589 articles, 37 articles were evaluated in detail and included in this review. Results: Magnetic resonance imaging (MRI) is the gold standard for post-operative monitoring of NFAs, although functional imaging modalities may improve identification of residual tumor in conjunction with MRI. The residual tumor can be distinguished from post-operative changes by experienced practitioners using high-resolution MRI in the immediate post-operative setting (within 1 week of surgery). However, continued imaging evolution in the appearance of residual tumor or resection cavity is expected up to 3 months post-operatively. Conclusions: Post-operative imaging appearance of the pituitary gland, optic apparatus, and pneumocephalus patterns, correlated with the clinical outcomes. Long-term, lifetime follow-up is warranted for NFA patients who underwent surgical resection.

Original languageEnglish (US)
Pages (from-to)1029-1039
Number of pages11
JournalActa Neurochirurgica
Volume160
Issue number5
DOIs
StatePublished - May 1 2018

Keywords

  • Computed tomography
  • Magnetic resonance imaging
  • Non-functioning pituitary adenomas
  • Post-operative

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