SAT-083 Overutilization of Surveillance Neuroimaging for Stable Microprolactinomas in Alberta
Notice bibliographique
Résumé
Abstract Disclosure: F. Mulji: None. J. Mann: None. B. Manoranjan: None. K. Lithgow: None. Background: Microprolactinomas are the most common type of pituitary adenoma with prevalence of ∼40 per 100,000. Medical therapy with dopamine agonist (DA) is first line treatment for symptomatic microprolactinomas. Neuroimaging with MRI sella is standard of care for imaging of microprolactinomas. Though guidelines suggest performing follow-up MRI sella one year after starting DA, a recent study of macroprolactinomas found no significant increases in tumour volume following normalization of prolactin over a mean follow-up of ten years, demonstrating that MRI surveillance in this setting is unnecessary. These findings present an opportunity to decrease health care resource utilization, particularily in microprolactinomas which are not associated with mass effect. We hypothesize that MRI sella is overutilized in the surveillance of stable microprolactinomas at our centre. Our primary aim is to assess practice patterns with respect to timing and frequency of surveillance neuroimaging for stable DA-treated microprolactinomas in our health region. Methods: This is a retrospective study inclusive of cases from 2003-2022. Potentially eligible cases were extracted by a data analyst. Inclusion criteria are 1) age > 18 years and 2) diagnosis of microprolactinoma (prolactin secreting adenoma <1 cm). Clinical variables for each eligible case were extracted including baseline tumour characteristics, baseline and follow-up prolactin, management strategy (DA vs. conservative management) and dates and results of all surveillance MRIs. Each case was reviewed to determine if there was an appropriate clinical indication for each MRI including 1) rising prolactin 2) neurological symptoms or concern for apoplexy 3) for planning surgery or radiation. Results: Initial data extraction yielded 1977 cases. Thus far, 213 cases have been screened, of which 20 meet our inclusion criteria (n=17 women, median age 32, IQR 5). Most cases (n=18) were managed initially with DA (n=11 cabergoline; n=9 bromocriptine). Median follow-up interval was 144 months (IQR 87) during which time a median of 4 surveillance MRIs were performed. A total of 89 surveillance MRIs were performed for all cases during the follow-up period, of which 73 (82%) did not have an appropriate clinical indication. Conclusion: Surveillance neuroimaging for stable microprolactinomas is overutilized at our centre. Further data extraction and analysis of this cohort is ongoing. Oure preliminary results illustrate opportunity to reduce healthcare costs and resource utilization. Presentation: Saturday, July 12, 2025
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
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