Asunto(s)
Adenoma Oxifílico , Neoplasias de la Corteza Suprarrenal , Humanos , Adenoma Oxifílico/patología , Adenoma Oxifílico/diagnóstico , Adenoma Oxifílico/diagnóstico por imagen , Neoplasias de la Corteza Suprarrenal/diagnóstico , Neoplasias de la Corteza Suprarrenal/patología , Neoplasias de la Corteza Suprarrenal/complicaciones , Femenino , Persona de Mediana Edad , Masculino , Anciano , AdultoAsunto(s)
Hipogonadismo , Síndrome de Kallmann , Masculino , Humanos , Adulto , Síndrome de Kallmann/complicaciones , GonadotropinasRESUMEN
OBJECTIVE: Hyperintensity signal in T2-weighted magnetic resonance imaging (MRI) has been related to better therapeutic response during pasireotide treatment in acromegaly. The aim of the study was to evaluate T2 MRI signal intensity and its relation with pasireotide therapeutic effectiveness in real-life clinical practice. DESIGN, PATIENTS AND MEASUREMENTS: Retrospective multicentre study including acromegaly patients treated with pasireotide. Adenoma T2-weighted MRI signal at diagnosis was qualitatively classified as iso-hyperintense or hypointense. Insulin-like growth factor (IGF-I), growth hormone (GH) and tumour volume reduction were assessed after 6 and 12 months of treatment and its effectiveness evaluated according to baseline MRI signal. Hormonal response was considered 'complete' when normalization of IGF-I levels was achieved. Significant tumour shrinkage was defined as a volume reduction of ≥25% from baseline. RESULTS: Eighty-one patients were included (48% women, 50 ± 1.5 years); 93% had previously received somatostatin receptor ligands (SRLs) treatment. MRI signal was hypointense in 25 (31%) and hyperintense in 56 (69%) cases. At 12 months of follow-up, 42/73 cases (58%) showed normalization of IGF-I and 37% both GH and IGF-I. MRI signal intensity was not associated with hormonal control. 19/51 cases (37%) presented a significant tumour volume shrinkage, 16 (41%) from the hyperintense group and 3 (25%) from the hypointense. CONCLUSIONS: T2-signal hyperintensity was more frequently observed in pasireotide treated patients. Almost 60% of SRLs resistant patients showed a complete normalization of IGF-I after 1 year of pasireotide treatment, regardless of the MRI signal. There was also no difference in the percentage tumour shrinkage over basal residual volume between the two groups.
Asunto(s)
Acromegalia , Adenoma , Hormona de Crecimiento Humana , Humanos , Femenino , Masculino , Acromegalia/tratamiento farmacológico , Acromegalia/diagnóstico , Factor I del Crecimiento Similar a la Insulina/metabolismo , Adenoma/complicaciones , Adenoma/diagnóstico por imagen , Adenoma/tratamiento farmacológico , Hormona de Crecimiento Humana/uso terapéutico , Imagen por Resonancia Magnética/métodos , Resultado del Tratamiento , Octreótido/uso terapéuticoAsunto(s)
Insuficiencia Suprarrenal/etiología , Adrenoleucodistrofia/diagnóstico , Miembro 1 de la Subfamilia D de Transportador de Casetes de Unión al ATP/genética , Adrenoleucodistrofia/complicaciones , Adrenoleucodistrofia/genética , Adulto , Diagnóstico Tardío , Proteínas de Transporte de Dopamina a través de la Membrana Plasmática/análisis , Dislipidemias/complicaciones , Femenino , Tamización de Portadores Genéticos , Asesoramiento Genético , Humanos , Radioisótopos de Yodo , Masculino , Persona de Mediana Edad , Nortropanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico por imagen , Mutación Puntual , Tomografía de Emisión de Positrones , Adulto JovenAsunto(s)
Quistes/complicaciones , Hipercalcemia/etiología , Hiperparatiroidismo Primario/etiología , Neoplasias de las Paratiroides/complicaciones , Conservadores de la Densidad Ósea/uso terapéutico , Enfermedades Óseas Metabólicas/tratamiento farmacológico , Enfermedades Óseas Metabólicas/etiología , Calcitonina/uso terapéutico , Colectomía , Enfermedades del Colon/etiología , Enfermedades del Colon/cirugía , Trastornos de la Conciencia/etiología , Quistes/diagnóstico , Quistes/cirugía , Diagnóstico por Imagen , Difosfonatos/uso terapéutico , Urgencias Médicas , Femenino , Furosemida/uso terapéutico , Humanos , Imidazoles/uso terapéutico , Perforación Intestinal/etiología , Perforación Intestinal/cirugía , Cálculos Renales/etiología , Persona de Mediana Edad , Hormona Paratiroidea/análisis , Neoplasias de las Paratiroides/diagnóstico , Neoplasias de las Paratiroides/cirugía , Paratiroidectomía , Tiroidectomía/métodos , Ácido ZoledrónicoRESUMEN
INTRODUCTION: Fine-needle aspiration biopsy (FNAB) is considered the reference diagnostic procedure for thyroid nodules. MATERIALS AND METHODS: Routine performance of thyroid ultrasound and ultrasound-guided FNAB by endocrinologists allows a more efficient approach in the setting of a high-resolution practice, thus reducing costs and the time elapsed until diagnosis. RESULTS: We present our initial results of this procedure 2 years after its introduction, with a total of 286 biopsies performed. After a progressive learning curve over time and according to the endocrinologists' previous experience, 72.72% samples were considered satisfactory for diagnosis. Greater difficulty was observed in obtaining optimal cytological specimens in smaller nodules. In conclusion, we have successfully incorporated thyroid ultrasound and ultrasound-guided FNAB into routine endocrine practice. CONCLUSION: Routine performance of thyroid ultrasound in endocrine practice will considerably aid the management of nodular thyroid disease.
