, Volume 53, Issue 1, pp 327–330 | Cite as

MRI T2 characteristics in somatotroph adenomas following somatostatin analog treatment in acromegaly

  • Ansgar Heck
  • Kyrre E. Emblem
  • Olivera Casar-Borota
  • Geir Ringstad
  • Jens Bollerslev
Research Letter


Magnetic resonance imaging (MRI) is the modality of choice to visualize pituitary adenomas in acromegaly. The signal intensity of T2 weighted MRI in somatotroph adenomas correlates with the histological subtypes, baseline characteristics and response to treatment with somatostatin analogs (SSA) [1, 2, 3, 4, 5]. SSA have antisecretory and antiproliferative effects on growth hormone (GH) producing adenomas, but resistance occurs in about a third of the patients treated with first generation SSA [6]. Therefore, T2 intensity may be used as a prognostic marker for response to pre- and postoperative SSA treatment and help guide treatment options in acromegaly [2, 3].

It is not known how SSA treatment affects T2 intensity in somatotroph adenomas. Furthermore, data on SSA treatment and its effect on granulation patterns are lacking. Recently, we have described a method for standardized, quantitative characterization of T2 intensity in GH producing adenomas [5]. In the present...


Adenoma Growth Hormone Acromegaly Pituitary Apoplexy Tumour Volume Reduction 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Compliance with ethical standards


AH has received speaker fees from Novartis, Ipsen, NovoNordisk, Pfizer and participated in Novartis’ nordic advisory board. KEE has intellectual property rights at NordicNeuroLab AS. JB has received an unrestricted research Grant from Novartis, Pfizer and Merck Norway AS. The other authors have nothing to disclose.


  1. 1.
    A. Hagiwara, Y. Inoue, K. Wakasa, T. Haba, T. Tashiro, T. Miyamoto, Comparison of growth hormone-producing and non-growth hormone-producing pituitary adenomas: imaging characteristics and pathologic correlation. Radiology 228(2), 533–538 (2003). doi: 10.1148/radiol.2282020695 CrossRefPubMedGoogle Scholar
  2. 2.
    M. Puig-Domingo, E. Resmini, B. Gomez-Anson, J. Nicolau, M. Mora, E. Palomera, C. Marti, I. Halperin, S.M. Webb, Magnetic resonance imaging as a predictor of response to somatostatin analogs in acromegaly after surgical failure. J. Clin. Endocrinol. Metab. 95(11), 4973–4978 (2010). doi: 10.1210/jc.2010-0573 CrossRefPubMedGoogle Scholar
  3. 3.
    A. Heck, G. Ringstad, S.L. Fougner, O. Casar-Borota, T. Nome, J. Ramm-Pettersen, J. Bollerslev, Intensity of pituitary adenoma on T2-weighted magnetic resonance imaging predicts the response to octreotide treatment in newly diagnosed acromegaly. Clin. Endocrinol. 77(1), 72–78 (2012). doi: 10.1111/j.1365-2265.2011.04286.x CrossRefGoogle Scholar
  4. 4.
    I. Potorac, P. Petrossians, A.F. Daly, F. Schillo, C. Ben Slama, S. Nagi, M. Sahnoun, T. Brue, N. Girard, T. Brue, P. Chanson, G. Nasser, P. Caron, F. Bonneville, G. Raverot, V. Lapras, F. Cotton, B. Delemer, B. Higel, A. Boulin, S. Gaillard, F. Luca, B. Goichot, J.L. Dietemann, A. Beckers, J.F. Bonneville, Pituitary MRI characteristics in 297 acromegaly patients based on T2-weighted sequences. Endocr. Relat. Cancer 22(2), 169–177 (2015). doi: 10.1530/ERC-14-0305 CrossRefPubMedGoogle Scholar
  5. 5.
    A. Heck, K.E. Emblem, O. Casar-Borota, J. Bollerslev, G. Ringstad, Quantitative analyses of T2-weighted MRI as a potential marker for response to somatostatin analogs in newly diagnosed acromegaly. Endocrine (2015). doi: 10.1007/s12020-015-0766-8 Google Scholar
  6. 6.
    S. Melmed, A. Colao, A. Barkan, M. Molitch, A.B. Grossman, D. Kleinberg, D. Clemmons, P. Chanson, E. Laws, J. Schlechte, M.L. Vance, K. Ho, A. Giustina, Acromegaly Consensus Group, Guidelines for acromegaly management: an update. J. Clin. Endocrinol. Metab. 94(5), 1509–1517 (2009). doi: 10.1210/jc.2008-2421 CrossRefPubMedGoogle Scholar
  7. 7.
    A. Obari, T. Sano, K. Ohyama, E. Kudo, Z.R. Qian, A. Yoneda, N. Rayhan, M. Mustafizur Rahman, S. Yamada, Clinicopathological features of growth hormone-producing pituitary adenomas: difference among various types defined by cytokeratin distribution pattern including a transitional form. Endocr. Pathol. 19(2), 82–91 (2008). doi: 10.1007/s12022-008-9029-z CrossRefPubMedGoogle Scholar
  8. 8.
    S.L. Asa, R. Digiovanni, J. Jiang, M.L. Ward, K. Loesch, S. Yamada, T. Sano, K. Yoshimoto, S.J. Frank, S. Ezzat, A growth hormone receptor mutation impairs growth hormone autofeedback signaling in pituitary tumors. Cancer Res. 67(15), 7505–7511 (2007). doi: 10.1158/0008-5472.CAN-07-0219 CrossRefPubMedGoogle Scholar
  9. 9.
    O. Casar-Borota, A. Heck, S. Schulz, J.M. Nesland, J. Ramm-Pettersen, T. Lekva, I. Alafuzoff, J. Bollerslev, Expression of SSTR2a, but not of SSTRs 1, 3, or 5 in somatotroph adenomas assessed by monoclonal antibodies was reduced by octreotide and correlated with the acute and long-term effects of octreotide. J. Clin. Endocrinol. Metab. 98(11), E1730–1739 (2013). doi: 10.1210/jc.2013-2145 CrossRefPubMedGoogle Scholar
  10. 10.
    L. Katznelson, E.R. Laws Jr, S. Melmed, M.E. Molitch, M.H. Murad, A. Utz, J.A. Wass, S. Endocrine, Acromegaly: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 99(11), 3933–3951 (2014). doi: 10.1210/jc.2014-2700 CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Ansgar Heck
    • 1
    • 2
  • Kyrre E. Emblem
    • 3
  • Olivera Casar-Borota
    • 4
    • 5
  • Geir Ringstad
    • 6
  • Jens Bollerslev
    • 1
    • 2
  1. 1.Section of Specialized Endocrinology, Department of EndocrinologyOslo University Hospital, RikshospitaletOsloNorway
  2. 2.Faculty of MedicineUniversity of OsloOsloNorway
  3. 3.The Intervention CentreOslo University Hospital, RikshospitaletOsloNorway
  4. 4.Department of Immunology, Genetics and PathologyUppsala UniversityUppsalaSweden
  5. 5.Department of PathologyOslo University HospitalOsloNorway
  6. 6.Department of Radiology and Nuclear MedicineOslo University Hospital, RikshospitaletOsloNorway

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