Is soft tissue radiology useful in acromegaly?

Area of Science:

• Endocrinology
• Radiology
• Medical Imaging

Background:

• Acromegaly is a hormonal disorder caused by excess growth hormone (GH).
• Effective monitoring of treatment response in acromegaly is crucial for patient outcomes.
• Radiological soft tissue measurements have been proposed as potential indicators of disease activity.

Purpose of the Study:

• To evaluate the utility of heel pad thickness and bone/soft tissue ratio as indicators for monitoring acromegaly patients post-treatment.
• To compare the changes in these radiological measurements with serum GH levels in response to therapy.

Main Methods:

• Twenty-six acromegaly patients underwent measurements of serum GH, heel pad thickness, and hand bone/soft tissue ratio before and 2-7 years after treatment.
• Treatments included transethmoidal hypophysectomy, external irradiation, or a combination.
• Patients were categorized based on clinical response: good responders versus unchanged/partial responders.

Main Results:

• Neither heel pad thickness nor bone/soft tissue ratio correlated with mean serum GH levels or each other, pre- or post-treatment.
• Patients with a good clinical response showed a significantly greater reduction in mean serum GH compared to partial/non-responders.
• No significant differences in the changes of heel pad thickness or bone/soft tissue ratio were observed between the response groups.

Conclusions:

• Heel pad thickness and bone/soft tissue ratio are unreliable radiological markers for assessing treatment efficacy in acromegaly.
• Serum GH level monitoring remains the primary method for evaluating treatment response in acromegaly.
• These radiological soft tissue measurements are deemed unhelpful in the clinical follow-up of acromegalic patients.