A Retrospective cohort study of Knosp grade reporting of cavernous sinus invasion in pituitary macroadenomas
Authors' conclusion
Despite the integral importance of CSI in pituitary adenoma management decisions as enshrined in international guidelines, the rate and accuracy of Knosp grade reporting are suboptimal.
Study context
- Population
- Patients with pituitary macroadenomas who underwent pituitary MR imaging between March 2023 and March 2025
- Participants
- 100 consecutive patients
- Outcome
- Rate and accuracy of Knosp grade reporting of cavernous sinus invasion (CSI) in radiologist reports
Methodological detailsobservational, consecutive patients
- Observational
- Consecutive patients
Main finding
As reported in the abstract
Knosp grade / CSI reporting by radiologists
- Reports with specific comment on cavernous sinus invasion (CSI) or its absence
- 73/100 (73%)
- Implicit reporting of specific Knosp grade (left and right sinuses separately)
- 12/200 (6%)
- Explicit reporting of Knosp grade (left and right sinuses separately)
- 10/200 (5%)
- Significant difference between reported Knosp grades and study panel grades
- p = 0.02
Observational data: associations, not effects.
Further findings
Correlation of CSI reporting rates with prior or concurrent treatment · before or at the time of the MRI
- No significant correlation with surgery
- P = 0.179
- No significant correlation with radiotherapy
- P = 0.427
- No significant correlation with medical therapy
- P = 0.127
Original publication
A Retrospective cohort study of Knosp grade reporting of cavernous sinus invasion in pituitary macroadenomas. Pituitary. Published 29 April 2026. doi:10.
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