The Utility of Magnetic Resonance Imaging for Hypophysitis Secondary to Immune Checkpoint Inhibitor Use
Authors' conclusion
Although changes were observed in a minority of patients with hypophysitis, MRI provides minimal additional clinically meaningful information, so it could be reserved for atypical cases or those with persisting symptoms despite adequate supplementation.
Study context
- Population
- Individuals who received ≥1 immune checkpoint inhibitor (ICI), January 2018–December 2023, single tertiary referral centre, Melbourne, Australiareceived ICI
- Participants
- 778 individuals
- Comparison
- ICI-related hypophysitis vs ICI-treated controls with normal pituitary function
- Hypophysitisn = 43
- Outcome
- Frequency of identifiable MRI changes
Methodological detailssingle tertiary referral centre
- Single tertiary referral centre
Main finding
As reported in the abstract
Acute hypophysitis changes on pituitary MRI after re-examination by an MRI-Fellowship trained radiologist · MRI within 2 months
Hypophysitis
23%
10 of 43
P = 0.003
- Initial reporting consistent with hypophysitis (Hypophysitis)
- 4 (9.3%)
Observational data: associations, not effects.
Further findings
- Atrophic pituitary and/or empty sella — Control
- 22%
- Initial magnetic resonance imaging (MRI) report consistent with hypophysitis
- 9.3% · 4 of 43
ICI-related hypophysitis incidence
- Diagnosed with ICI-related hypophysitis
- 54 (6.9%) of 778
Initial MRI report consistent with hypophysitis
- All initial MRI reports normal in controls
Other pituitary pathology
- No other significant pituitary pathology, including pituitary metastasis, identified
Original publication
The Utility of Magnetic Resonance Imaging for Hypophysitis Secondary to Immune Checkpoint Inhibitor Use. Clin Endocrinol (Oxf). Published 24 March 2025. doi:10.
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