Risk of new endocrinological deficits after intraoperative MRI-guided additional resection in endoscopic non-functioning pituitary adenoma surgery
Authors' conclusion
IoMRI-guided additional resection during TSS for NFPAs can be performed safely without increasing the risk of new EDs.
Study context
- Population
- Patients with histologically confirmed NFPA undergoing endoscopic transsphenoidal surgery with 3-Tesla intraoperative magnetic resonance imaging (ioMRI), July 2013–July 2022; median age 60 years, 59% maleof 312 screened
- Participants
- 155 patients
- Exposure
- ioMRI-guided additional resection vs no additional resection
- Outcome
- New endocrinological deficits (EDs) of at least one pituitary axis
Methodological detailsprospectively collected data, 3-Tesla ioMRI, endoscopic transsphenoidal surgery with "chopsticks" technique
- Prospectively collected data
- 3-Tesla ioMRI
- Endoscopic transsphenoidal surgery with "chopsticks" technique
Main finding
As reported in the abstract
New EDs of at least one pituitary axis
New endocrinological deficits (EDs) at discharge
23%
n = 35
New EDs at first follow-up (6 weeks)
25%
n = 38
New EDs at final follow-up
18%
n = 28
Observational data: associations, not effects.
Further findings
Gross total resection (GTR) rate
- ioMRI GTR rate
- 35%
- GTR on 3-month postoperative MRI after ioMRI-guided additional resection
- 65% (n = 98)
- Additional resection following ioMRI
- 46% (n = 71)
Any recovery of preoperative EDs · discharge, 6 weeks, final follow-up
- Recovery at discharge
- 9.7%
- Recovery at first follow-up
- 31%
- Recovery at final follow-up
- 45%
Original publication
Risk of new endocrinological deficits after intraoperative MRI-guided additional resection in endoscopic non-functioning pituitary adenoma surgery. Pituitary. Published 11 July 2026. doi:10.
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