Evidence map›Paper›PMID 32763900›Full record

ArticleAJNR. American journal of neuroradiology2020

MRI Findings of Immune Checkpoint Inhibitor-Induced Hypophysitis: Possible Association with Fibrosis.

R Kurokawa, Y Ota, W Gonoi, A Hagiwara, M Kurokawa, H Mori, E Maeda, S Amemiya, Y Usui, N Sato and 3 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in AJNR. American journal of neuroradiology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed
2.7field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

29 citing papers in PubMed, 48 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 2 countries.

R KurokawaFrom the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.ORCID 0000-0002-1186-8900
Y OtaDivision of Neuroradiology (Y.O., T.M.), Department of Radiology, Michigan Medicine, Ann Arbor, Michigan.ORCID 0000-0001-8992-2156
W GonoiFrom the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan watapi-tky@umin.net.ORCID 0000-0002-5018-4683
A HagiwaraDepartment of Radiology (A.H.), Juntendo University School of Medicine, Tokyo, Japan.ORCID 0000-0001-5277-3249
M KurokawaDepartment of Radiology (M.K.), Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.ORCID 0000-0002-3907-9188
H MoriDepartment of Radiology (H.M.), Jichi Medical University, Tochigi-ken, Japan.ORCID 0000-0003-1370-5272
E MaedaFrom the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.ORCID 0000-0003-2123-9187
S AmemiyaFrom the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.ORCID 0000-0002-2132-1642
Y UsuiFrom the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.ORCID 0000-0001-9537-1717
N SatoDepartment of Radiology (N.S.), Tokyo Metropolitan Neurological Hospital, Tokyo, Japan.ORCID 0000-0002-9305-7131
Y NakataDepartment of Radiology (Y.N.), National Center of Neurology and Psychiatry, Tokyo, Japan.ORCID 0000-0001-7238-7951
T MoritaniDivision of Neuroradiology (Y.O., T.M.), Department of Radiology, Michigan Medicine, Ann Arbor, Michigan.ORCID 0000-0002-4909-8526
O AbeFrom the Department of Radiology (R.K., W.G., E.M., S.A., Y.U., O.A.), Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.ORCID 0000-0002-1180-2629
The University of Tokyo · JPMichigan Medicine · USJichi Medical University · JPJuntendo University · JPNational Center of Neurology and Psychiatry · JPTokyo Metropolitan Komagome Hospital · JPTokyo Metropolitan Neurological Hospital · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeHypophysitis is one of the well-known adverse effects of immune checkpoint inhibitors. Immune checkpoint inhibitor-induced hypophysitis frequently causes irreversible hypopituitarism, which requires long-term hormone replacement. Despite the high frequency and clinical significance, characteristic MR imaging findings of immune checkpoint inhibitor-induced hypophysitis have not been established. In the present study, we aimed to review and extract the MR imaging features of immune checkpoint inhibitor-induced hypophysitis. MATERIALS AND

methodsThis retrospective international multicenter study comprised 20 patients with melanoma who were being treated with immune checkpoint inhibitors and clinically diagnosed with immune checkpoint inhibitor-induced hypophysitis. Three radiologists evaluated the following MR imaging findings: enlargement of the pituitary gland and stalk; homogeneity of enhancement of the pituitary gland; presence/absence of a well-defined poorly enhanced area and, if present, its location, shape, and signal intensity in T2WI; and enhancement pattern in contrast-enhanced dynamic MR imaging. Clinical symptoms and hormone levels were also recorded.

resultsEnlargement of the pituitary gland and stalk was observed in 12 and 20 patients, respectively. Nineteen patients showed poorly enhanced lesions (geographic hypoenhancing lesions) in the anterior lobe, and 11 of these lesions showed hypointensity on T2WI. Thyrotropin deficiency and corticotropin deficiency were observed in 19/20 and 12/17 patients, respectively, which persisted in 12/19 and 10/12 patients, respectively, throughout the study period.

conclusionsPituitary geographic hypoenhancing lesions in the anterior lobe of the pituitary gland are characteristic and frequent MR imaging findings of immune checkpoint inhibitor-induced hypophysitis. They reflect fibrosis and are useful in distinguishing immune checkpoint inhibitor-induced hypophysitis from other types of hypophysitis/tumors.

Indexed as

AdultAgedAged, 80 and overCutaneous Malignant MelanomaFemaleFibrosisHumansHypophysitisImmune Checkpoint InhibitorsMagnetic Resonance ImagingMaleMelanomaMiddle AgedRetrospective StudiesSkin NeoplasmsImmune Checkpoint Inhibitors

Identifiers

PMID32763900
PMCPMC7583108
OpenAlexW3047684932

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.