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

Data de publicação: 08/07/2023 Data Ahead of Print: 01/07/2023

Autores da FMUP

Davide Maurício Costa Carvalho

Autor

Participantes de fora da FMUP

Ruiz, S
Gil, J
Biagetti, B
Venegas, E
Camara, R
Garcia-Centeno, R
Galvez, MA
Pico, A
Maraver, S
Gonzalez, I
Abellan, P
Trincado, P
Herrera, M
Olvera, P
Xifra, G
Bernabeu, I
Serra-Soler, G
Azriel, S
Garcia, L
Jordà, M
Valassi, E
Puig, J
Puig-Domingo, M

Unidades de investigação

Medicina

Abstract

ObjectiveHyperintensity 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 MeasurementsRetrospective 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 & GE;25% from baseline. ResultsEighty-one patients were included (48% women, 50 & PLUSMN; 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. ConclusionsT2-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.

Dados da publicação

ISSN/ISSNe:: 1365-2265, 0300-0664
Tipo:: Article
Páginas:: 378-385
DOI:: 10.1111/cen.14946
Link para outro recurso:: www.scopus.com

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Keywords

acromegaly; IGF-1; magnetic resonance imaging; pasireotide; somatostatin receptor ligands; T2-weighted signal intensity

Campos de estudo

Financiamento

Instituto de Salud Carlos III (PI22/01364)

Instituto de Salud Carlos III (PMP15/00027)

Instituto de Salud Carlos III (PMP22/00021)

Proyectos asociados

Acromegalia: Metabolismo da Glicose Como Possível Preditor de Tumores Mais Agressivos

Investigador Principal: Davide Maurício Costa Carvalho

Estudo Clínico Académico . 2022

Diabetic Neuropathy, Central Nervous System Plasticity and Metabolic Disfunction