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Updated: May 29, 2026
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Intraoperative MRI for transphenoidal procedures: short-term outcome for 100 consecutive cases
Todd W Vitaz1, Kofi E Inkabi, Christopher J Carrubba
1Brain Tumor Center, Norton Neuroscience Institute, Louisville, KY, United States. todd.vitaz@nortonhealthcare.org
Clinical Neurology and Neurosurgery
|September 6, 2011
Summary
Intraoperative MRI (iMRI) in pituitary surgery improves gross total resection rates and aids visualization. Further follow-up is needed to confirm long-term tumor control benefits.
Area of Science:
- Neurosurgery
- Medical Imaging
- Endocrinology
Background:
- Pituitary lesions are often benign and curable with resection.
- Transsphenoidal surgery, while common, has visualization limits.
- Incomplete resection leads to higher recurrence rates.
Purpose of the Study:
- To evaluate the impact of intraoperative MRI (iMRI) on pituitary surgery outcomes.
- To assess the safety and efficacy of iMRI-guided transsphenoidal pituitary surgery.
- To compare iMRI-assisted outcomes with published data.
Main Methods:
- 100 patients underwent transnasal transsphenoidal surgery with iMRI (GE Signa SP 0.5T).
- Prospective follow-up assessed intraoperative findings, imaging, and clinical outcomes.
- Tumor resection extent, recurrence, and complications were evaluated.
Main Results:
- Average resection was 96%; 76% achieved gross total resection via iMRI.
- Major complications occurred in 4% of patients with large macroadenomas.
- Postoperative CSF leaks (6%) and adjuvant treatment needs (9%) were observed.
Conclusions:
- iMRI provides immediate radiographic feedback, aiding visualization in pituitary surgery.
- iMRI may lead to fewer complications and higher gross total resection rates.
- Long-term tumor control impact of iMRI requires further investigation.
