Introduction: Confirmation of the status of residual pituitary adenomas is the key to determining further treatment. Prophylactic radiation therapy may be unnecessary, and complications of radiation are common. Therefore, to exactly evaluate the status of tumor determines the application of further treatments. The geometric calculation formula in ellipsoidal mass, which has been used for a long time, is 1/2(Length*Width*Height, L*W*H). However we all know that it is a rough method, particularly in irregular-shaped mass, such as residual tumor. In our study, we try to adapt a more delicate method to calculate the volume and compare with the traditional formula.
Methods: From 2005~2014, 94 patients with pituitary tumors underwent a total of 104 operations; 10 patients underwent a second operation. All patients received pre- and post-operative Magnetic Resonance Imaging (MRI). We calculated the tumor volume in two methods based on the same MRI. The pre-operative volume calculated by ½ L*W*H was grouped as A1, and by ‘OsiriX’ as O1. The post-operative volume calculated by ½ L*W*H was grouped as A2, and ‘OsiriX’ as O2.
Results: The Wilcoxon rank test showed no statistical difference between A1 and O1 groups (p=0.1810). There is statistically significant difference between A2 and O2 groups (p<0.0001). In pre-operative cases with statistical differences (difference=1 standard deviation), There are statistical differences regarding high grade cavernous sinus invasion (p=0.0312), and irregular shape (p=0.0116). There are no statistical differences regarding suprasellar extension (p=0.2977), and apoplexy (p=0.1928).
Conclusions: The volume plays an important role in evaluating the tumor status, and determining the subsequent treatment. The traditional formula is not precise enough that the growth of residual tumor might be over- or even underestimated, leading to inappropriate management. Therefore, we suggest to adopting a more scientific method, especially when these lesions are irregular-shaped or when the treatment is determined exclusively based on the volume of tumor.
Patient Care: My research will improve patient care by measuring the precise tumor volume, determine the tumor status, therefore to prevent side effects and complications from unnecessary treatment. Finally to determine the real beneficial treatment for patient with residual or recurrent pituitary adenomas.
Learning Objectives: By the conclusion of this session, participants should be able to: 1)realize that the precise volume measurement is the key to determining tumor status and subsequent treatment policies., 2)avoid side effects and complications from unnecessary treatment, such as radiation therapy., 3)determine the real beneficial treatment for patient with residual or recurrent pituitary adenomas.