Assessment of the extent of pituitary macroadenomas resection in immediate postoperative MRI

López, E. Taberner; Molina, Matías; Gregori, Julia Calatayud; Sanz, Marc Jornet; Fayos, J. Jornet; Campo, Arantzazu; Gómez, A. Caño; Olmos, Enrique Mollà

doi:10.1016/j.rxeng.2017.10.006

Cited by 9 publications

(2 citation statements)

References 18 publications

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“…Post-surgical pituitary MRI, along with intraoperative observations, helps assess the surgical resection and tumor remnants, allowing, at an early stage, for a tailored plan for following treatments [18,32].…”

Section: Discussionmentioning

confidence: 99%

“…In some cases, achieving gross total resection (GTR) may be challenging [14] due to various clinical factors that can interfere with complete resection. These factors include tumor size and consistency, invasiveness [15], tumor shape [16], nodular extensions [17], and the inability to visualize the entire tumor bed directly during the procedure [18]. Especially in these latter cases, an early post-operative MRI is a crucial step to overcome the limits of surgical observation.…”

Section: Introductionmentioning

confidence: 99%

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Trouillas’s Grading and Post-Surgical Tumor Residue Assessment in Pituitary Adenomas: The Importance of the Multidisciplinary Approach

Calandrelli,

Mattogno,

Chiloiro

et al. 2024

Diagnostics

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Background: We aim to assess the role of a multidisciplinary approach in pituitary adenomas (PitNETs) classification, evaluate criteria concordance, and compare intraoperative assessments with post-operative MRIs for tumor remnants. Methods: Clinical, radiological, histological, and intra- and post-operative data of the treated PitNETs were extracted from prospectively created records. PitNETs were graded according to Trouillas, and the evaluation of the tumor remnants was recorded. Results: Of 362 PitNETs, 306 underwent surgery, with Trouillas grading assigned to 296. Eight-nine radiologically non-invasive PitNETs progressed to grades 1b (27), 2a (42), or 2b (20) due to proliferative or surgical invasiveness criteria. Twenty-six radiologically invasive tumors were graded 2b due to proliferative criteria. Surgical resection details and post-surgical MRI findings revealed that residual tumors were more common in grades 2a and 2b. During surgery, small tumor remnants were documented in 14 patients which were not visible on post-surgical MRI. Post-surgical MRIs identified remnants in 19 PitNETs not seen during surgery, located in lateral recesses of the sella (4), retrosellar (2), or suprasellar regions (7), along the medial wall of the cavernous sinus (6). Conclusions: The Pituitary Board allows for the correct grading of PitNETs to be obtained and an accurate identification of high-risk patients who should undergo closer surveillance due to tumor remnants.

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Section: Discussionmentioning

confidence: 99%