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Physicians’ awareness of gadolinium retention and MRI timing practices in the longitudinal management of pituitary tumors: a “Pituitary Society” survey

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Abstract

Purpose

In view of mounting attention related to possible brain retention of gadolinium-based contrast agents (GBCAs) in patients with normal renal function, our purpose was to detail results from a survey of pituitary experts to assess: 1) the timing interval and frequency of pituitary magnetic resonance imaging (MRI) following surgical and/or medical and/or radiation therapy of pituitary tumors, 2) awareness of the types of GBCAs used and their possible safety issues.

Methods

The Pituitary Society Education Committee composed a survey with 12 multiple choice questions, 8 of which specifically addressed the time interval and frequency of MRI in the longitudinal management of pituitary tumors. The survey was distributed at two meetings; the International Pituitary Neurosurgeons Society conference in San Diego, CA, on February 18th, 2018, and the Pituitary Society Membership and Career Development Forum, Chicago, IL on March 18th, 2018.

Results

There is consensus among pituitary endocrinologists and neurosurgeons that long-term repeated imaging is recommended in most pituitary tumors, although the precise strategy of timing varied depending on the specialist group and the specific clinical context of the adenoma. The data also suggest that International Pituitary Neurosurgeons Society neurosurgeons, as well as Pituitary Society neuroendocrinologists, are sometimes unaware of which contrast agents are used by their institution, and many are also unaware that evidence of long-term brain retention has been reported with the use of GBCAs in patients with normal function.

Conclusions

International pituitary endocrinologists and pituitary neurosurgeons experts suggest ongoing MRIs for the management of pituitary tumors; strategies vary based on clinical context, but also on individual experience and practice.

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Funding

No funding has been received for this project.

Author information

Authors and Affiliations

  1. Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School Boston, Boston, MA, USA

    Lisa B. Nachtigall

  2. Institute of Metabolism and Systems Research, College of Medical and Dental Sciences, Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, University of Birmingham, Birmingham, UK

    Niki Karavitaki

  3. Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado School of Medicine at Colorado Anschutz Medical Campus, Aurora, CO, USA

    Katja Kiseljak-Vassiliades

  4. Division of Endocrinology, Ohio State University, Columbus, OH, USA

    Luma Ghalib

  5. Division of Diabetes and Endocrinology, Kobe University Hospital, Kobe, Japan

    Hidenori Fukuoka

  6. Department of Neurosurgery, Hospital Pablo Tobon Uribe and Clinica Medellin, Medellín, Colombia

    Luis V. Syro

  7. Pacific Neuroscience Institute & John Wayne Cancer Institute, Santa Monica, CA, USA

    Daniel Kelly

  8. Departments of Medicine and Neurological Surgery, Northwest Pituitary Center, Oregon Health & Science University, Mail Code: CH8N, 3303 SW Bond Ave., Portland, OR, 97239, USA

    Maria Fleseriu

Authors
  1. Lisa B. Nachtigall
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  2. Niki Karavitaki
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  6. Luis V. Syro
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  7. Daniel Kelly
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Correspondence to Maria Fleseriu.

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Appendix: Questionnaire; questions 1–12. Supplementary material 1 (DOCX 21 KB)

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Nachtigall, L.B., Karavitaki, N., Kiseljak-Vassiliades, K. et al. Physicians’ awareness of gadolinium retention and MRI timing practices in the longitudinal management of pituitary tumors: a “Pituitary Society” survey. Pituitary 22, 37–45 (2019). https://doi.org/10.1007/s11102-018-0924-0

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  • DOI: https://doi.org/10.1007/s11102-018-0924-0

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