Serial 3 T magnetic resonance imaging during cabergoline treatment of macroprolactinomas.
OBJECTIVE
Cabergoline is the treatment of choice for prolactin (PRL)-producing pituitary adenomas, because of its efficacy in normalizing PRL levels, and inducing tumor shrinkage. The clinical use of 3 T magnetic resonance imaging (MRI) for neuroimaging has rapidly expanded in recent years. In particular, T2-weighted imaging (T2WI) provides high anatomical and contrast resolution.


METHODS
In this study, serial 3 T MRI with T2WI was utilized during cabergoline treatment of 10 patients with macroprolactinomas. Cabergoline was started at a standard weekly dosage and incrementally adjusted on individual posttreatment PRL values.


RESULTS
MRI confirmed tumor shrinkage in all patients during cabergoline treatment. Cabergoline normalized hyperprolactinemia in all but one patient. In six of 10 patients, distinct low-signal-intensity areas were evident throughout the adenomas on T2WI. In four of those six patients, massive low-signal-intensity areas appeared at 1-4 months, after which tumors decreased in size by over 80%. These findings in the early phase of prolactinoma treatment predicted pronounced regression or near-complete disappearance of the tumor. Reduction of T2 intensity possibly reflected dehydration due to diffuse hemorrhage in the adenomas.


CONCLUSIONS
T2-weighted 3 T MR images are valuable for assessing and monitoring cabergoline treatment of macroprolactinomas.
Masamichi
M
Kurosaki
Atsushi
A
Kambe
Takashi
T
Watanabe
Shinya
S
Fujii
Toshihide
T
Ogawa
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000077465:Cabergoline; D018491:Dopamine Agonists / Q000627:therapeutic use; D004873:Ergolines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D015175:Prolactinoma / Q000188:drug therapy* / Q000473:pathology*; D055815:Young Adult
D000970:Antineoplastic Agents; D018491:Dopamine Agonists; D004873:Ergolines; D000077465:Cabergoline
3 T MRI,; Cabergoline; Prolactinoma,