title: Brain abnormalities on MRI in non-functioning pituitary adenoma patients treated with or without postoperative radiotherapy.
abstract: OBJECTIVE
  To assess and compare brain abnormalities on Magnetic Resonance Imaging (MRI) in non-functioning pituitary macro-adenoma (NFA) patients treated with or without postoperative radiotherapy (RT).
  
  
  METHODS
  In 86 NFA patients, treated between 1987 and 2008 at the University Medical Center Groningen, white-matter lesions (WMLs), cerebral atrophy, brain infarctions and abnormalities of the temporal lobes and hippocampi were assessed on pre- and post-treatment MRI scans in patients treated with (n=47) or without RT.
  
  
  RESULTS
  The median MRI follow-up time for RT patients was 10 (range 1-22) years and 5 (range 1-21) years in patients treated without RT. In RT patients the cumulative incidence of WMLs was significantly lower compared to patients treated without RT (log-rank test RR 0.49, 95% CI 0.25-0.97, p=.042). The cumulative incidences of cerebral atrophy, brain infarctions, abnormalities of the temporal lobes and hippocampi, and the severity of WMLs and cerebral atrophy ratings were not significantly different between the two treatment groups.
  
  
  CONCLUSIONS
  Brain abnormalities on MRI are not observed more frequently in NFA patients treated with RT compared to patients treated with surgery-alone. Furthermore, RT was not associated with an increased severity of WMLs and cerebral atrophy ratings in this cohort of NFA patients.
authors.affiliation: Departments of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands; Department of Radiation Oncology, Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands. Electronic address: g.a.sattler@umcg.nl.
authors.forename: Margriet G A
authors.initials: MG
authors.lastname: Sattler
authors.affiliation: Department of Radiology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Linda C
authors.initials: LC
authors.lastname: Meiners
authors.affiliation: Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Wim J
authors.initials: WJ
authors.lastname: Sluiter
authors.affiliation: Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Gerrit
authors.initials: G
authors.lastname: van den Berg
authors.affiliation: Departments of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
authors.affiliation: Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Bruce H R
authors.initials: BH
authors.lastname: Wolffenbuttel
authors.affiliation: Departments of Radiation Oncology, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: Alphons C M
authors.initials: AC
authors.lastname: van den Bergh
authors.affiliation: Department of Endocrinology and Metabolic Diseases, University of Groningen, University Medical Center Groningen, The Netherlands.
authors.forename: André P
authors.initials: AP
authors.lastname: van Beek
mesh_terms: D000236:Adenoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D000328:Adult; D000368:Aged; D001284:Atrophy; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology*; D020520:Brain Infarction / Q000175:diagnosis / Q000209:etiology; D002540:Cerebral Cortex / Q000473:pathology / Q000528:radiation effects; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000528:radiation effects; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011184:Postoperative Period; D011832:Radiation Injuries / Q000175:diagnosis / Q000209:etiology; D013702:Temporal Lobe / Q000473:pathology / Q000528:radiation effects; D066127:White Matter / Q000473:pathology / Q000528:radiation effects; D055815:Young Adult
keywords: Brain side effects; MR imaging; Non-functioning pituitary adenomas; Postoperative radiotherapy; Surgery