Magnetic resonance imaging as a predictor of therapeutic response to pasireotide in acromegaly
Ruiz-Janer, Sabina (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Gil, Joan (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Biagetti, Betina (Hospital Universitari Vall d'Hebron)
Venegas, Eva (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Cámara, Rosa (Hospital Universitari i Politècnic La Fe (València))
Garcia-Centeno, Rogelio (Hospital Universitario Gregorio Marañón)
Gálvez, María Ángeles (Hospital Universitario Reina Sofía (Andalusia))
Picó Alfonso, Antonio M. (Hospital General Universitario de Alicante (Alacant, País Valencià))
Maraver, Silvia (Hospital Universitario Virgen de la Victoria (Andalusia))
González, Inmaculada (Hospital Regional Universitario de Málaga)
Abellán-Galiana, Pablo (Hospital General Universitario de Castelló)
Trincado, Pablo (Hospital Universitario Miguel Servet (Saragossa))
Herrera, Mayte T. (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Olvera, Pilar (Hospital Universitario Nuestra Señora de Candelaria (Santa Cruz de Tenerife))
Xifra, Gemma (Hospital Universitari de Girona Doctor Josep Trueta)
Bernabeu Morón, Ignacio (Complejo Universitario de Santiago de Compostela)
Serra-Soler, Guillermo (Hospital Universitari Son Espases (Illes Balears))
Azriel, Sharona (Hospital Universitario Infanta Sofía (Madrid))
García, Lourdes (Hospital Universitario de Jerez (Illes Canàries))
Carvalho, Davide (Centro Hospitalar Universitário de São João (Portugal))
Jordà, Mireia (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Valassi, Elena (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Puig, Josep (Hospital Universitari de Girona Doctor Josep Trueta)
Puig Domingo, Manuel (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Universitat Autònoma de Barcelona

Data:	2023
Resum:	Objective: Hyperintensity signal in T2-weighted magnetic resonance imaging (MRI) has been related to better therapeutic response during pasireotide treatment in acromegaly. The aim of the study was to evaluate T2 MRI signal intensity and its relation with pasireotide therapeutic effectiveness in real-life clinical practice. Design, Patients and Measurements: Retrospective multicentre study including acromegaly patients treated with pasireotide. Adenoma T2-weighted MRI signal at diagnosis was qualitatively classified as iso-hyperintense or hypointense. Insulin-like growth factor (IGF-I), growth hormone (GH) and tumour volume reduction were assessed after 6 and 12 months of treatment and its effectiveness evaluated according to baseline MRI signal. Hormonal response was considered 'complete' when normalization of IGF-I levels was achieved. Significant tumour shrinkage was defined as a volume reduction of ≥25% from baseline. Results: Eighty-one patients were included (48% women, 50 ± 1. 5 years); 93% had previously received somatostatin receptor ligands (SRLs) treatment. MRI signal was hypointense in 25 (31%) and hyperintense in 56 (69%) cases. At 12 months of follow-up, 42/73 cases (58%) showed normalization of IGF-I and 37% both GH and IGF-I. MRI signal intensity was not associated with hormonal control. 19/51 cases (37%) presented a significant tumour volume shrinkage, 16 (41%) from the hyperintense group and 3 (25%) from the hypointense. Conclusions: T2-signal hyperintensity was more frequently observed in pasireotide treated patients. Almost 60% of SRLs resistant patients showed a complete normalization of IGF-I after 1 year of pasireotide treatment, regardless of the MRI signal. There was also no difference in the percentage tumour shrinkage over basal residual volume between the two groups.
Ajuts:	Instituto de Salud Carlos III PI22/01364 Ministerio de Economía y Competitividad PMP15/00027 Instituto de Salud Carlos III PMP22/00021
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Publicat a:	Clinical Endocrinology, Vol. 99 Núm. 4 (october 2023) , p. 378-385, ISSN 1365-2265

DOI: 10.1111/cen.14946

8 p, 366.3 KB

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