AB092. Imaging the histopathology subtypes of the growth hormone-secreting pituitary neuroendocrine tumor
Abstract

AB092. Imaging the histopathology subtypes of the growth hormone-secreting pituitary neuroendocrine tumor

Jiun-Lin Yan1, Cheng-Han Yang2, Shih-Ming Jung2, Pin-Yuan Chen1, Wan-Chin Kan3, Chen-Nen Chang1

1Department of Neurosurgery, Keelung Chang Gung Memorial Hospital, Keelung; 2Department of Pathology, Chang Gung Memorial Hospital, Taoyuan; 3Department of Radiology, Chang Gung Memorial Hospital, Taoyuan

Correspondence to: Jiun-Lin Yan, MD, PhD. Keelung Chang Gung Memorial Hospital, 222 Mai-Jin Road, Keelung. Email: color_genie@hotmail.com.

Background: Sparsely granulated (SG) growth hormone-secreting pituitary neuroendocrine tumors (GH-PitNETs) often present with a more aggressive clinical course compared to densely granulated (DG) tumors. These subtypes exhibit distinct biological and imaging characteristics. Thus, this study aims to differentiate between the histopathological subtypes of GH-PitNETs using pre-operative magnetic resonance imaging (MRI).

Methods: A retrospective analysis was conducted on 83 acromegalic patients treated at our institution between 2000 and 2010. Tumor volumes were segmented from preoperative MRIs, including T1-weighted, T2-weighted, T1 with contrast, and T2 fluid attenuated inversion recovery (FLAIR) sequences. Reference regions of interest (ROIs) were delineated using gray and white matter from the same sequences. Two pathologists reviewed pathology specimens for anti-cytokeratin (CAM 5.2) and Pit-1 expression. Clinical and radiological biomarkers were compared between SG and DG patients.

Results: A total of 83 patients with complete histopathology and 51 patients with complete MRIs were included in the analysis. SG PitNETs exhibited higher rates of supra-sellar invasion (61.5%, P<0.001), larger tumor sizes, lower pre-operative GH levels, and increased post-operative residual tumor (65.4%, P<0.001) compared to DG PitNETs. Additionally, SG PitNETs showed greater hyperintensity on T2-weighted images and enhanced contrast, whereas DG PitNETs exhibited less contrast enhancement. Utilization of these imaging biomarkers demonstrated an 94.1% accuracy in T2 FLAIR and overall of 78.7% predicting the histopathological subtypes of GH-PitNETs.

Conclusions: Distinct histopathological subtypes of GH-PitNETs represent crucial prognostic factors. Utilizing multimodal pre-operative MRIs, clinicians can accurately identify sparsely granulated GH-PitNETs, facilitating improved treatment planning strategies.

Keywords: Pituitary tumor; acromegaly; growth hormone; magnetic resonance imaging (MRI); granulation pattern

Acknowledgments

Funding: This study was funded by the research grant from Chang Gang Medical Research Foundation (No. CMRPG2N0021).

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab092/coif). J.L.Y. received travel funding from Clearmind to attend the conference for the presentation about minimal invasive intracerebral hemorrhagic stroke which is not related to this submitted abstract. The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). This study was approved by the Institutional board review (IRB No. 202200500B0) and individual consent for this retrospective analysis was waived.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this abstract as: Yan JL, Yang CH, Jung SM, Chen PY, Kan WC, Chang CN. AB092. Imaging the histopathology subtypes of the growth hormone-secreting pituitary neuroendocrine tumor. Chin Clin Oncol 2024;13(Suppl 1):AB092. doi: 10.21037/cco-24-ab092

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