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Pituitary magnetic resonance imaging in Cushing’s disease

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Abstract

Adrenocorticotropin-secreting pituitary tumor represents about 10 % of pituitary adenomas and at the time of diagnosis most of them are microadenomas. Transsphenoidal surgery is the first-line treatment of Cushing’s disease and accurate localization of the tumor within the gland is essential for selectively removing the lesion and preserving normal pituitary function. Magnetic resonance imaging is the best imaging modality for the detection of pituitary tumors, but adrenocorticotropin-secreting pituitary microadenomas are not correctly identified in 30–50 % of cases, because of their size, location, and enhancing characteristics. Several recent studies were performed with the purpose of better localizing the adrenocorticotropin-secreting microadenomas through the use in magnetic resonance imaging of specific sequences, reduced contrast medium dose and high-field technology. Therefore, an improved imaging technique for pituitary disease is mandatory in the suspect of Cushing’s disease. The aims of this paper are to present an overview of pituitary magnetic resonance imaging in the diagnosis of Cushing’s disease and to provide a magnetic resonance imaging protocol to be followed in case of suspicion adrenocorticotropin-secreting pituitary adenoma.

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Acknowledgments

This review is part of the “Altogether to Beat Cushing’s Syndrome Group” led by Prof Annamaria Colao, which aims at increasing the knowledge on Cushing’s Syndrome. The authors would like to acknowledge all the Collaborators of this project: Albani A., Albiger N., Ambrogio A., Arnaldi G., Arvat E., Baldelli R., Barbot M., Boscaro M., Campo M., Cannavò S., Canu L. Cappabianca Paolo, Castinetti F., Cavagnini F., Cavallo L.M., Chiodini I., Ciresi A., Cirillo S., Cocchiara F., Colao A., Corsello S.M., Cozzolino A., Damiani L., De Leo M., De Martino M.C., Farese A., Feelders R., Ferone D., Gatto F., Graziadio C., Grimaldi F., Iacuaniello D., Isidori A.M., Karamouzis I., Lenzi A., Loli P., Mannelli M., Mantovani G., Marcelli G., Marzullo P., Minniti G., Palmieri S., Paragliola R.M., Pasquali R., Pecori Giraldi F., Pivonello C., Pivonello R., Reincke M., Sbardella E., Scaroni C., Simeoli C., Spada A., Stigliano A., Tortora F., Toscano V., Trementino L., Vitale G., Zampetti B., Zatelli M.C., and Zhukouskaya O.

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Authors and Affiliations

  1. Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy

    Giovanni Vitale

  2. Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy

    Giovanni Vitale

  3. Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale “F. Magrassi e A. Lanzara”, Second University of Naples, Naples, Italy

    Fabio Tortora

  4. UOSD Endocrinologia, Istituto Nazionale Tumori “Regina Elena” -Roma, Rome, Italy

    Roberto Baldelli

  5. Endocrinology, Department of Internal Medicine and Medical Specialities (DiMI), IRCCS AOU San Martino-IST, University of Genova, Genova, Italy

    Francesco Cocchiara

  6. Endocrinology, Università Cattolica del Sacro Cuore, Rome, Italy

    Rosa Maria Paragliola

  7. Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy

    Emilia Sbardella

  8. Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy

    Chiara Simeoli, Rosario Pivonello & Annamaria Colao

  9. Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy

    Ferdinando Caranci

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  1. Giovanni Vitale
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Vitale, G., Tortora, F., Baldelli, R. et al. Pituitary magnetic resonance imaging in Cushing’s disease. Endocrine 55, 691–696 (2017). https://doi.org/10.1007/s12020-016-1038-y

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