title: T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly.
abstract: GH-secreting pituitary adenomas can be hypo-, iso- or hyper-intense on T2-weighted MRI sequences. We conducted the current multicenter study in a large population of patients with acromegaly to analyze the relationship between T2-weighted signal intensity on diagnostic MRI and hormonal and tumoral responses to somatostatin analogs (SSA) as primary monotherapy. Acromegaly patients receiving primary SSA for at least 3 months were included in the study. Hormonal, clinical and general MRI assessments were performed and assessed centrally. We included 120 patients with acromegaly. At diagnosis, 84, 17 and 19 tumors were T2-hypo-, iso- and hyper-intense, respectively. SSA treatment duration, cumulative and mean monthly doses were similar in the three groups. Patients with T2-hypo-intense adenomas had median SSA-induced decreases in GH and IGF-1 of 88% and 59% respectively, which were significantly greater than the decreases observed in the T2-iso- and hyper-intense groups (P < 0.001). Tumor shrinkage on SSA was also significantly greater in the T2-hypo-intense group (38%) compared with the T2-iso- and hyper-intense groups (8% and 3%, respectively; P < 0.0001). The response to SSA correlated with the calculated T2 intensity: the lower the T2-weighted intensity, the greater the decrease in random GH (P < 0.0001, r = 0.22), IGF-1 (P < 0.0001, r = 0.14) and adenoma volume (P < 0.0001, r = 0.33). The T2-weighted signal intensity of GH-secreting adenomas at diagnosis correlates with hormone reduction and tumor shrinkage in response to primary SSA treatment in acromegaly. This study supports its use as a generally available predictive tool at diagnosis that could help to guide subsequent treatment choices in acromegaly.
authors.affiliation: CHU de Liège-University of LiègeLiège, Belgium.
authors.forename: Iulia
authors.initials: I
authors.lastname: Potorac
authors.affiliation: CHU de Liège-University of LiègeLiège, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Petrossians
authors.affiliation: CHU de Liège-University of LiègeLiège, Belgium.
authors.forename: Adrian F
authors.initials: AF
authors.lastname: Daly
authors.affiliation: Université Catholique de LouvainBrussels, Belgium.
authors.forename: Orsalia
authors.initials: O
authors.lastname: Alexopoulou
authors.affiliation: CHU Jean MinjozBesancon, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Borot
authors.affiliation: CHU MarseilleMarseille, France.
authors.forename: Mona
authors.initials: M
authors.lastname: Sahnoun-Fathallah
authors.affiliation: CHU MarseilleMarseille, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Castinetti
authors.affiliation: Université Libre de BruxellesBruxelles, Belgium.
authors.forename: France
authors.initials: F
authors.lastname: Devuyst
authors.affiliation: Department of Biotechnological and Applied Clinical SciencesUniversity of L'Aquila and Neuroendocrinology, Neuromed IRCCS, Pozzilli, Italy.
authors.forename: Marie-Lise
authors.initials: ML
authors.lastname: Jaffrain-Rea
authors.affiliation: CHU AngersAngers, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Briet
authors.affiliation: CHU StrasbourgStrasbourg, France.
authors.forename: Florina
authors.initials: F
authors.lastname: Luca
authors.affiliation: CHU LyonLyon, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Lapoirie
authors.affiliation: Universitätsklinikum ErlangenErlangen, Germany.
authors.forename: Flavius
authors.initials: F
authors.lastname: Zoicas
authors.affiliation: CHU BocageDijon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Simoneau
authors.affiliation: CHU ReimsReims, France.
authors.forename: Alpha M
authors.initials: AM
authors.lastname: Diallo
authors.affiliation: Erasmus University Medical Center RotterdamRotterdam, Netherlands.
authors.forename: Ammar
authors.initials: A
authors.lastname: Muhammad
authors.affiliation: Faculty of MedicineErciyes University, Kayseri, Turkey.
authors.forename: Fahrettin
authors.initials: F
authors.lastname: Kelestimur
authors.affiliation: University of GenovaGenova, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Nazzari
authors.affiliation: Hospital Universitario Gregorio MarañonMadrid, Spain.
authors.forename: Rogelio Garcia
authors.initials: RG
authors.lastname: Centeno
authors.affiliation: Hospital Sant PauCentro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER, Unidad 747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Webb
authors.affiliation: CHU BordeauxBordeaux, France.
authors.forename: Marie-Laure
authors.initials: ML
authors.lastname: Nunes
authors.affiliation: Charles UniversityPrague, Czech Republic.
authors.forename: Vaclav
authors.initials: V
authors.lastname: Hana
authors.affiliation: CHU NancyNancy, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Pascal-Vigneron
authors.affiliation: Moscow Regional Research and Clinical InstituteRussia.
authors.forename: Irena
authors.initials: I
authors.lastname: Ilovayskaya
authors.affiliation: Kazan State Medical AcademyKazan, Russia.
authors.forename: Farida
authors.initials: F
authors.lastname: Nasybullina
authors.affiliation: Centre Pierre et Marie CurieAlgiers, Algeria.
authors.forename: Samia
authors.initials: S
authors.lastname: Achir
authors.affiliation: University of GenovaGenova, Italy.
authors.forename: Diego
authors.initials: D
authors.lastname: Ferone
authors.affiliation: Erasmus University Medical Center RotterdamRotterdam, Netherlands.
authors.forename: Sebastian J C M M
authors.initials: SJ
authors.lastname: Neggers
authors.affiliation: CHU ReimsReims, France.
authors.forename: Brigitte
authors.initials: B
authors.lastname: Delemer
authors.affiliation: CHU BocageDijon, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Petit
authors.affiliation: Center of Endocrinology & MetabolismBamberg, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Schöfl
authors.affiliation: CHU LyonLyon, France.
authors.forename: Gerald
authors.initials: G
authors.lastname: Raverot
authors.affiliation: CHU StrasbourgStrasbourg, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Goichot
authors.affiliation: CHU AngersAngers, France.
authors.forename: Patrice
authors.initials: P
authors.lastname: Rodien
authors.affiliation: Université Libre de BruxellesBruxelles, Belgium.
authors.forename: Bernard
authors.initials: B
authors.lastname: Corvilain
authors.affiliation: CHU MarseilleMarseille, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Brue
authors.affiliation: CHU Jean MinjozBesancon, France.
authors.forename: Franck
authors.initials: F
authors.lastname: Schillo
authors.affiliation: CHU de Liège-University of LiègeLiège, Belgium.
authors.forename: Luaba
authors.initials: L
authors.lastname: Tshibanda
authors.affiliation: Université Catholique de LouvainBrussels, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Maiter
authors.affiliation: CHU de Liège-University of LiègeLiège, Belgium.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Bonneville
authors.affiliation: CHU de Liège-University of LiègeLiège, Belgium albert.beckers@chu.ulg.ac.be.
authors.forename: Albert
authors.initials: A
authors.lastname: Beckers
mesh_terms: D000172:Acromegaly / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D000236:Adenoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D011379:Prognosis; D013004:Somatostatin / Q000031:analogs & derivatives*; D016896:Treatment Outcome; D047368:Tumor Burden / Q000187:drug effects
chemical_list: D019382:Human Growth Hormone; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; D015282:Octreotide
keywords: MRI; acromegaly; predictor; somatostatin analogs; treatment response