Radiological Surveillance for Pituitary Adenomas in Multiple Endocrine Neoplasia Type 1: A Longitudinal Cohort Study

Area of Science:

• Endocrinology
• Oncology
• Radiology

Background:

• Patients with Multiple Endocrine Neoplasia Type 1 (MEN1) have a genetic predisposition to tumors in the parathyroid, pancreas, and pituitary.
• The role of radiological surveillance for pituitary adenomas in MEN1 patients is not well-defined.

Purpose of the Study:

• To assess the impact of pituitary MRI findings on the management of patients with MEN1.

Main Methods:

• Retrospective longitudinal cohort study of genetically confirmed MEN1 patients.
• Analysis of pituitary MRI findings and subsequent interventions for non-functional adenomas.
• Evaluation of the rate of intervention and factors prompting MRI.

Main Results:

• 57% of MEN1 patients developed pituitary adenomas; 52% of these were non-functional.
• Only 22% of non-functional adenomas required intervention, primarily driven by symptoms or abnormal pituitary function.
• Most non-functional adenomas remained stable, and few MRIs were prompted by clinical abnormalities.

Conclusions:

• Routine radiological surveillance for non-functional pituitary adenomas in MEN1 provides minimal additional benefit.
• Management decisions should prioritize patient-reported symptoms and pituitary function testing.
• Individualized imaging strategies may reduce unnecessary MRI scans.