October - December 2010, Volume 6, Issue 4

Berker M, Hazer D, Çehreli M, Salmon P, Akça K, Tekdemir I

Micro CT analysis of sellar floor in pituitary adenomas, especially in Cushing's disease

Acta Endo (Buc) 2010, 6 (4): 481-492
doi: 10.4183/aeb.2010.481

Context. The aim of this study was to explore the prognostic significance correlation between the endocrinopathy and the size of the pituitary adenoma with the sellar floor bone mineral density values using microfocus computerized tomography (μCT) analysis. Subjects and Methods. 16 consecutive patients with pituitary adenomas had full endocrinological and radiological work up prior to endoscopic transnasal transsphenoidal surgery. Multiple bony samples were collected from the sellar floor during surgery, and labeled and analyzed in a double blind fashion. Each bone sample was analyzed for bone mineral density (BMD) and Hounsfield units (HU) with microfocus CT. Results. There was no correlation between adenoma size and BMD values of sella floor but grade IV macroadenomas were found to have lower BMD levels. Statistical analysis showed that the level of correlation between grouped BMD (<1.0 and >1.0) data with ACTH (<46 and >46), IGF (<303 and >303), and PRL (<29.93 and >29.93) levels were insignificant (P=.569, P=.315, and P=1.00, respectively) Conclusion. We have found no clinical relationship between sellar floor BMD values and endocrinopathy and the size of the adenoma. However, it was found out that preoperative conventional CT evaluation seemed insufficient in predicting the sellar floor bone integrity and may mislead the surgeon.

Keywords: erosion, microfocus computerized tomography, pituitary adenoma, sella turcica, Cushing disease

Correspondence: Derya Burcu Hazer MD, Çankiri State Hospital - Neurosurgery Çankiri State Hospital, Department of Neurosurgery Akso Mah. 18100, Çankiri 18100.Turkey Tel: 90.376.2129299 Fax: 90.376.3189892 Email: burcuhazer@hotmail.com