title: Pituitary magnetic resonance imaging in Cushing's disease.
abstract: Adrenocorticotropin-secreting pituitary tumor represents about 10 % of pituitary adenomas and at the time of diagnosis most of them are microadenomas. Transsphenoidal surgery is the first-line treatment of Cushing's disease and accurate localization of the tumor within the gland is essential for selectively removing the lesion and preserving normal pituitary function. Magnetic resonance imaging is the best imaging modality for the detection of pituitary tumors, but adrenocorticotropin-secreting pituitary microadenomas are not correctly identified in 30-50 % of cases, because of their size, location, and enhancing characteristics. Several recent studies were performed with the purpose of better localizing the adrenocorticotropin-secreting microadenomas through the use in magnetic resonance imaging of specific sequences, reduced contrast medium dose and high-field technology. Therefore, an improved imaging technique for pituitary disease is mandatory in the suspect of Cushing's disease. The aims of this paper are to present an overview of pituitary magnetic resonance imaging in the diagnosis of Cushing's disease and to provide a magnetic resonance imaging protocol to be followed in case of suspicion adrenocorticotropin-secreting pituitary adenoma.
authors.affiliation: Department of Clinical Sciences and Community Health (DISCCO), University of Milan, Milan, Italy. giovanni.vitale@unimi.it.|Laboratory of Endocrine and Metabolic Research, Istituto Auxologico Italiano IRCCS, Milan, Italy. giovanni.vitale@unimi.it.
authors.forename: Giovanni
authors.identifier: http://orcid.org/0000-0003-2478-683X
authors.initials: G
authors.lastname: Vitale
authors.affiliation: Dipartimento Medico-Chirurgico di Internistica Clinica e Sperimentale "F. Magrassi e A. Lanzara", Second University of Naples, Naples, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Tortora
authors.affiliation: UOSD Endocrinologia, Istituto Nazionale Tumori "Regina Elena" -Roma, Rome, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Baldelli
authors.affiliation: Endocrinology, Department of Internal Medicine and Medical Specialities (DiMI), IRCCS AOU San Martino-IST, University of Genova, Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cocchiara
authors.affiliation: Endocrinology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Rosa Maria
authors.initials: RM
authors.lastname: Paragliola
authors.affiliation: Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Sbardella
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Simeoli
authors.affiliation: Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Caranci
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Pivonello
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università Federico II di Napoli, Naples, Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Colao
mesh_terms: D000236:Adenoma / Q000000981:diagnostic imaging*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D047748:Pituitary ACTH Hypersecretion / Q000000981:diagnostic imaging*; D010902:Pituitary Gland / Q000000981:diagnostic imaging*; D010911:Pituitary Neoplasms / Q000000981:diagnostic imaging*
keywords: Cushing’s disease; Imaging; MRI; Pituitary microadenoma