Evidence map›Paper›PMID 42435115›Full record

ArticlePituitary2026

Risk of new endocrinological deficits after intraoperative MRI-guided additional resection in endoscopic non-functioning pituitary adenoma surgery.

Stefanos Voglis, Meltem Gönel, Maria Triantafyllidou, Victor Staartjes, Gianluca Mosca, Jacopo Bellomo, Benjamin Beyersdorf, Kevin Akeret, Bas van Niftrik, Michael Hugelshofer and 4 more

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Article in Pituitary, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Stefanos Voglis *Department of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-1514-1442
Meltem Gönel *Department of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Maria TriantafyllidouDepartment of Endocrinology, University Hospital and University of Zurich, Zurich, Switzerland.
Victor StaartjesDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Gianluca MoscaDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Jacopo BellomoDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Benjamin BeyersdorfDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Kevin AkeretDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Bas van NiftrikDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Michael HugelshoferDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Bettina WinzelerDepartment of Endocrinology, University Hospital and University of Zurich, Zurich, Switzerland.
Zoran ErlicDepartment of Endocrinology, University Hospital and University of Zurich, Zurich, Switzerland.
Luca RegliDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland.
Carlo SerraDepartment of Neurosurgery, Clinical Neuroscience Center, University Hospital, University of Zurich, Zurich, Switzerland. carlo.serra@usz.ch.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveIntraoperative magnetic resonance imaging (ioMRI) has been increasingly used in transsphenoidal surgery for pituitary adenomas to improve the rate of gross total resection (GTR). However, its influence on postoperative pituitary function-particularly the risk of new endocrinological deficits (EDs) due to an additional resection-has not been investigated in detail. This study aimed to evaluate the endocrinological outcomes of ioMRI-guided TSS in patients with nonfunctioning pituitary adenomas (NFPAs), with a focus on the risk of new EDs following ioMRI-guided additional resection.

methodsWe performed a retrospective cohort analysis of prospectively collected data from 312 patients who underwent endoscopic transsphenoidal surgery with the "chopsticks" technique between July 2013 and July 2022. Of these, 155 patients met the inclusion criteria: histologically confirmed NFPA phenotype and 3-Tesla ioMRI usage. All patients had at least 3 months of endocrinological and MRI follow-up. Hormonal outcomes were reviewed by a dedicated endocrinologist using clinical and biochemical assessments.

resultsAmong the 155 included patients (median age 60 years; 59% male), the ioMRI GTR rate was 35%; this increased to 65% (n = 98) on 3‑month postoperative MRI as a result of ioMRI‑guided additional resection. Overall, additional resection following ioMRI was performed in 46% (n = 71) of cases. New EDs of at least one pituitary axis were observed in 23% (n = 35) of patients at discharge, 25% (n = 38) at first follow-up (6 weeks postoperatively), and 18% (n = 28) at final follow-up in total. Any recovery of preoperative EDs occurred in 9.7%, 31% and 45% respectively. Uni- and multivariate logistic regression analysis showed that neither GTR, tumor volume, residual tumor volume nor additional resection following ioMRI were associated with increased risk of new deficits.

conclusionsIoMRI-guided additional resection during TSS for NFPAs can be performed safely without increasing the risk of new EDs. These findings support the utility of ioMRI in maximizing the extent of resection while preserving pituitary function.

Indexed as

AdenomaMagnetic Resonance ImagingPituitary NeoplasmsAdultAgedEndoscopyFemaleHumansMaleMiddle AgedRetrospective StudiesEndocrinological deficitsExtent of resectionIntraoperative MRIOutcomePituitary adenoma

Identifiers

PMID42435115
PMCPMC13356093

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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.