Serial 3 T magnetic resonance imaging during cabergoline treatment of macroprolactinomas. (April 2015)

• Record Type: Journal Article
• Authors: Kurosaki, Masamichi; Kambe, Atsushi; Watanabe, Takashi; Fujii, Shinya; Ogawa, Toshihide
• Is Part Of: Neurological research. Volume 37:Number 4(2015)
• Page Start: 341
• Page End: 346
• Publication Date: 2015-04
• Subjects: 3 T MRI, -- Prolactinoma, -- Cabergoline; Neurology -- Periodicals; Neurosciences -- Periodicals; 616.8005
• DOI: 10.1179/1743132814Y.0000000457
• Languages: English
• ISSNs: 0161-6412

Abstract

Abstract : 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. Patients and 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. Conclusion: T2-weighted 3 T MR images are valuable for assessing and monitoring cabergoline treatment of macroprolactinomas.