MR Imaging of Pituitary Adenomas After Gamma Knife Stereotactic Radiosurgery
Glenn A. Tung1,
Georg Noren2,
Jeffrey M. Rogg1 and
Ivor M.D. Jackson3
1
Department of Diagnostic Imaging, Brown University School of Medicine, Rhode
Island Hospital, 593 Eddy St., Providence, RI 02903.
2
Department of Neurosurgery, Brown University School of Medicine, Rhode Island
Hospital, Providence, RI 02903.
3
Division of Endocrinology, Department of Medicine, Brown University School of
Medicine, Rhode Island Hospital, Providence, RI 02903.
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Fig. 1. —Graph shows change in pituitary adenoma size after gamma
knife radiosurgery.
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Fig. 2A. —68-year-old man with nonsecretory macroadenoma and
symptomatic left optic nerve compression 6 months after radiosurgery. Enhanced
coronal T1-weighted MR image (TR/TE, 800/23) obtained in stereotactic head
frame shows homogeneously enhancing macroadenoma that compresses prechiasmatic
left optic nerve (arrow).
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Fig. 2B. —68-year-old man with nonsecretory macroadenoma and
symptomatic left optic nerve compression 6 months after radiosurgery. Six
months after radiosurgery, patient presented with deterioration of vision and
temporal field cut. Coronal enhanced T1-weighted MR image (433/23) shows
enlargement of upper half of tumor, decreased contrast enhancement, and
increased compression of optic chiasm.
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Fig. 3A. —65-year-old man with gradual reduction of
follicle-stimulating hormone-secreting macroadenoma after gamma knife
radiosurgery. Coronal T1-weighted MR image (TR/TE, 400/11) in stereotactic
frame shows optic chiasm bowed over convex upper border of macroadenoma, which
has tumor volume of 19.3 cm3.
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Fig. 3B. —65-year-old man with gradual reduction of
follicle-stimulating hormone-secreting macroadenoma after gamma knife
radiosurgery. Follow-up enhanced T1-weighted coronal MR image (500/12)
obtained 1 year after radiosurgery shows 55% reduction in tumor volume.
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Fig. 3C. —65-year-old man with gradual reduction of
follicle-stimulating hormone-secreting macroadenoma after gamma knife
radiosurgery. Enhanced T1-weighted coronal MR image performed 2 years after
radiosurgery shows tumor with concave upper border and volume of 8.1
cm3. There has been no change in contrast enhancement pattern.
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Fig. 4A. —47-year-old man with nonsecretory macroadenoma. Before gamma
knife radiosurgery, enhanced coronal T1-weighted MR image (TR/TE, 600/17)
shows enhancing dumbbell-shaped pituitary tumor that compresses optic chiasm
(arrow).
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Fig. 4B. —47-year-old man with nonsecretory macroadenoma. Six months
after radiosurgery, enhanced T1-weighted MR image (500/20) shows tumor
enlargement. Contrast enhancement is more heterogeneous and is reduced
centrally.
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Fig. 4C. —47-year-old man with nonsecretory macroadenoma. MR image
obtained 1 year after radiosurgery shows 50% reduction in tumor volume, and
adenoma no longer compresses chiasm (arrow). Contrast-enhancement
pattern is more homogeneous.
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Fig. 4D. —47-year-old man with nonsecretory macroadenoma. Follow-up MR
image obtained 2 years after radiosurgery shows 71% reduction in tumor
volume.
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Copyright © 2001 by the American Roentgen Ray Society.
