Magnetic resonance imaging as a predictor of therapeutic response to pasireotide in acromegaly.

Autor: Ruiz S; Germans Trias i i Pujol Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain., Gil J; Germans Trias i i Pujol Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain., Biagetti B; Servei d'Endocrinología i Nutrició, Hospital Universitari Vall d'Hebrón, Barcelona, Spain., Venegas E; Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen del Rocío, Sevilla, Spain., Cámara R; Servicio de Endocrinología y Nutrición, Hospital Universitario La Fe, Valencia, Spain., Garcia-Centeno R; Servicio de Endocrinología y Nutrición, Hospital Universitario Gregorio Marañón, Madrid, Spain., Gálvez MÁ; Servicio de Endocrinología y Nutrición, Hospital Universitario Reina Sofía, Córdoba, Spain., Picó A; Servicio de Endocrinología y Nutrición, Hospital General Universitario de Alicante, Alicante, Spain., Maraver S; Servicio de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria, Málaga, Spain., González I; Servicio de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, Málaga, Spain., Abellán P; Servicio de Endocrinología y Nutrición, Hospital General Universitario de Castellón, Castellón de la Plana, Spain., Trincado P; Servicio de Endocrinología y Nutrición, Hospital Universitario Miguel Servet, Zaragoza, Spain., Herrera M; Servicio de Endocrinología y Nutrición, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain., Olvera P; Servicio de Endocrinología y Nutrición, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain., Xifra G; Servei d'Endocrinologia i Nutrició, Hospital Universitari Josep Trueta, Girona, Spain., Bernabeu I; Servicio de Endocrinología y Nutrición, Complejo Universitario de Santiago de Compostela, Santiago de Compostela, Spain., Serra-Soler G; Servicio de Endocrinología y Nutrición, Hospital Universitario Son Espases, Palma de Mallorca, Spain., Azriel S; Servicio de Endocrinología y Nutrición, Hospital Universitario Infanta Sofía, Madrid, Spain., García L; Servicio de Endocrinología y Nutrición, Hospital Universitario de Jerez, Cádiz, Spain., Carvalho D; Servicio de Endocrinología, Diabetes y Metabolismo, Centro Hospitalar Universitário de São João, FMUP, i3s, Porto, Portugal., Jordà M; Germans Trias i i Pujol Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain., Valassi E; Germans Trias i i Pujol Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain., Puig J; Centre de Medicina Comparada i Bioimatge, IGTP, Badalona, Spain.; Servei de Radiologia, Hospital Universitari Josep Trueta, IDIBGi, Girona, Spain., Puig-Domingo M; Germans Trias i i Pujol Research Institute and Hospital, Universitat Autònoma de Barcelona, Badalona, Spain.
Jazyk: angličtina
Zdroj: Clinical endocrinology [Clin Endocrinol (Oxf)] 2023 Oct; Vol. 99 (4), pp. 378-385. Date of Electronic Publication: 2023 Jul 08.
DOI: 10.1111/cen.14946
Abstrakt: 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.
(© 2023 The Authors. Clinical Endocrinology published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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