Early Postoperative Magnetic Resonance Imaging for Transsphenoidal Pituitary Surgery: A Systemic Literature Review...

Current neurosurgical consensus guidelines recommend that the first radiologic study to evaluate the extent of pituitary tumor resection be performed 3-4 months after surgery, defined as late postoperative (LPO) magnetic resonance imaging (MRI), and include fat-suppressed T1 and T2 sequences. The current guidelines supporting LPO MRI stem from older studies which claim that imaging <3 months postoperatively, defined as early postoperative (EPO), cannot be reliably interpreted due to acute postoperative changes. Several new technical and technological innovations that emerged since the promulgation of these guidelines may allow neurosurgeons to evaluate the extent of pituitary adenoma resection within a shorter timeframe, with higher resolution, and with greater certainty of the surrounding anatomy. We therefore sought to develop an evidence-based imaging algorithm, with regard to timing, magnetic field strength, and choice of views, for postoperative MRI following transsphenoidal pituitary adenoma resection by performing a systematic review of the available literature.