title: Quantitative volumetric analysis post transsphenoidal pituitary adenoma surgery.
abstract: BACKGROUND
  Computed tomogram (CT) imaging is often used for immediate postoperative assessment of transsphenoidal pituitary adenoma resection while magnetic resonance imaging (MRI) is used for follow-up. The residual mass is known to decrease in size over time but the difference between the two imaging modalities has not been quantified. Our objective was to quantify the size difference of the residual mass on immediate postoperative CT compared with delayed MRI.
  
  
  METHODS
  Retrospective analysis of 69 patients who had undergone pituitary adenoma resection at our institution between 2004-2010. Sellar and suprasellar diameter, along with the overall volume of the residual mass were measured on both the immediate postoperative CT and delayed MRI.
  
  
  RESULTS
  Average preoperative sellar and suprasellar diameter was 22.2 ± 4.6mm and 20.9 ± 5.9mm, respectively. Average sellar residual diameter on immediate postoperative CT (16.5 ± 5.4 mm, 25% reduction) was significantly larger than delayed MRI (10.6 ± 6.2mm, 52% reduction). The average suprasellar component on CT (15.5±6.5mm, 26% reduction) was also significantly larger than that on MRI (3.3 ± 5.4 mm, 84% reduction). The postoperative CT showed a 46% reduction in volume while a 71% reduction was noted on the delayed MRI.
  
  
  CONCLUSIONS
  A significant reduction in residual mass is noted on delayed MR imaging compared with immediate postoperative CT. Therefore, from a resource management and prognostication point of view, CT should be used for immediate postoperative assessment while delayed MRI should be used to assess operative success and for communication with patients.
authors.affiliation: Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Alireza
authors.initials: A
authors.lastname: Mansouri
authors.forename: Sean
authors.initials: S
authors.lastname: Symons
authors.forename: Michael
authors.initials: M
authors.lastname: Schwartz
authors.forename: Joseph
authors.initials: J
authors.lastname: Chen
authors.forename: Farhad
authors.initials: F
authors.lastname: Pirouzmand
mesh_terms: D000236:Adenoma / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007016:Hypophysectomy; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D010911:Pituitary Neoplasms / Q000473:pathology* / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D012658:Sella Turcica / Q000601:surgery; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome