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Published on: September 3, 2013
MR imaging of pituitary adenomas treated with the prolactin inhibitor quinagolide
E Ilkko1, T Tikkakoski, P Salmela
1Department of Diagnostic Radiology, Oulu University Hospital, Finland.
Purpose:
To evaluate the volume of micro- and macroadenomas in quinagolide-treated patients with resistance to or intolerance of bromocriptine.
Material And Methods:
The effect of the prolactin inhibitor quinagolide on the volume of pituitary adenoma was evaluated retrospectively in 11 female patients. Prolactin levels before and after the treatment were also recorded. The indications for quinagolide therapy were side-effects of bromocriptine in 5 cases, a poor response to bromocriptine in 5 cases and both in 1 case. MR imaging with a 1.0-T magnet was performed to determine the volume reduction of the adenomas.
Results:
The average volume reduction of macroadenomas was 324 mm3 (46%) and that of microadenomas 73 mm3 (57%). The level of prolactin secreted by macroadenomas was reduced by an average of 163 microg/l (65%) and that by microadenomas of 113 microg (73%). In 2 microadenomas and in 1 macroadenoma, signal intensity changed during the treatment in T1-weighted images. In follow-up no changes in signal intensity were seen in 8 adenomas in non-contrast T1-weighted images. A haemorrhagic lesion was seen in 1 macroadenoma before treatment, but it disappeared during treatment.
Conclusion:
Quinagolide was found to be an effective alternative to bromocriptine in cases with drug intolerance or resistance, and MR imaging a suitable method for the follow-up of macro- and microadenomas.
Insights
Quinagolide effectively reduced pituitary adenoma volume in patients intolerant or resistant to bromocriptine. Magnetic resonance imaging (MRI) proved suitable for monitoring micro- and macroadenomas.
Area of Science:
- Endocrinology
- Radiology
- Oncology
Background:
- Pituitary adenomas, particularly prolactinomas, are often treated with dopamine agonists like bromocriptine.
- Resistance or intolerance to bromocriptine necessitates alternative therapeutic strategies.
- Evaluating the efficacy of alternative treatments and monitoring tumor response is crucial.
Purpose of the Study:
- To assess the impact of quinagolide on pituitary adenoma volume in patients with bromocriptine resistance or intolerance.
- To compare the effectiveness of quinagolide in reducing both micro- and macroadenomas.
- To evaluate prolactin level changes during quinagolide treatment.
Main Methods:
- Retrospective analysis of 11 female patients treated with quinagolide.
- Magnetic resonance (MR) imaging using a 1.0-T magnet to measure adenoma volume before and after treatment.
- Recording of prolactin levels pre- and post-quinagolide therapy.
Main Results:
- Significant average volume reduction observed in both macroadenomas (46%) and microadenomas (57%).
- Substantial decrease in secreted prolactin levels for both macroadenomas (65%) and microadenomas (73%).
- MR imaging revealed changes in signal intensity and resolution of a hemorrhagic lesion during treatment.
Conclusions:
- Quinagolide serves as an effective alternative treatment for pituitary adenomas when bromocriptine is not tolerated or effective.
- Magnetic resonance imaging is a valuable tool for monitoring the volume changes of pituitary adenomas during quinagolide therapy.
- The study supports quinagolide as a viable option for managing pituitary adenomas in specific patient populations.
