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Congress: ECR25
Poster Number: C-14720
Type: Poster: EPOS Radiologist (educational)
Authorblock: P. Suphannapornsuk, V. Charoonratana, N. Sanghan; Songkhla/TH
Disclosures:
Praphatsorn Suphannapornsuk: Author: none
Vorawan Charoonratana: Advisory Board: none
Nuttha Sanghan: Advisory Board: none
Keywords: Neuroradiology brain, MR, Imaging sequences, Laboratory tests, Outcomes analysis, Endocrine disorders
Learning objectives Currently, there is a lack of predictive factors for the tumor response to dopamine agonists in prolactinomas. This study aims to determine the MRI feature changes between before and after Bromocriptine therapy which could be a predictor of hormonal and/or tumoral response.
Read more Background This retrospective study included rolactinoma patients treated with dopamine agonists (DAs) at Songklanagarind Hospital over a 19-year period (2005–2024). Patients aged ≥15 years with complete baseline and 1-year follow-up MRI were included, excluding those with incomplete imaging, poor compliance, or prior pituitary surgery.Pituitary MRI findings were analyzed for tumor dimensions, cystic/hemorrhagic components, and invasive features (e.g., cavernous sinus and optic chiasm invasion). Statistical methods, including logistic regression and Fisher’s exact test, identified key predictors of treatment response, defined as ≥50%...
Read more Findings and procedure details This study analyzed 91 prolactinoma patients treated with bromocriptine over 19 years at Songklanagarind Hospital. Among them, 86 had non-cystic prolactinomas, and 5 had cystic prolactinomas. MRI findings, prolactin levels, and predictors of treatment response were thoroughly evaluated, with the following key findings: Patient Characteristics: The majority of patients were female (78.0%), with a mean age of 36.7 years (SD 12.4). Dyslipidemia was the most common comorbidity, affecting 10.8% of patients. The study primarily focused on non-cystic prolactinomas. Pre-treatment MRI Findings: MRI...
Read more Conclusion MRI characteristics provide valuable insights into prolactinoma response to bromocriptine therapy. Tumor size, cystic components, and invasion patterns play critical roles in predicting treatment success. Sphenoid sinus and optic chiasm invasions were strong predictors of favorable outcomes, while cavernous sinus invasion was associated with poor responses. Cystic changes post-treatment were impacted to prolactin level, though hemorrhagic changes was statistic significant in post treatment changes, but were not predictive of hormonal response. These findings can aid clinicians in optimizing treatment strategies...
Read more References Casanueva FF, Molitch ME, Schlechte JA, Abs R, Bonert V, Bronstein MD, et al. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol (Oxf). 2006;65(2):265-73. Fukuhara N, Nishiyama M, Iwasaki Y. Update in Pathogenesis, Diagnosis, and Therapy of Prolactinoma. Cancers (Basel). 2022;14(15). Gillam MP, Molitch ME, Lombardi G, Colao A. Advances in the treatment of prolactinomas. Endocrine reviews. 2006;27(5):485-534. Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, et al. Diagnosis and treatment of hyperprolactinemia:...
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