Endocrine Abstracts

We audited 46 pituitary MRI scans for patients with hypogonadotropic hypogonadism. We were particularly interested to see if adopting The Endocrine Society’s (TES) 2010 guidelines for Testosterone Therapy in Men with Androgen Deficiency Syndromes (pituitary MRIs only for those with testosterone level below 5.3 mmol/l, panhypopituitarism, persistent hyperprolactinaemia or if the patient has symptoms consistent with a mass effect such as headaches, a visual field defect or visual impairment) in our department could potentially result in fewer unnecessary MRI scans being performed and therefore saving time, money, resources and, most importantly of all, saving patients from having unnecessary scans. 49 patients were identified who had been booked for MRI scans of their pituitary glands at Queen Alexandra Hospital with the indication ‘hypogonadotrophic hypogonadism’. These scans dated from March 2015 to January 2017. Two patients were female and therefore removed from the numbers and one patient had never attended for the scan so was also removed from the numbers. Out of the 46 scanned male patients, 13 (28%) had a structural pituitary abnormality on their MRI – 7 of these abnormalities were small pituitaries or empty or nearly empty sellas. One macroadenoma and two microadenomas were found. Four of the scanned patients had biochemical profiles and documented histories which, according TES guidelines meant they did not require a scan – indeed all of their scans were normal. 19 patients had a documented indication for an MRI according to TES guidelines and 6 of those had abnormalities on their scans. For the remaining 23 patients, the documentation was unclear whether they had indications for their scans and 7 of them had structural abnormalities on their scans. These results support The Endocrine Society’s guidelines for pituitary MRIs in hypogonadotropic hypogonadism patients since the patients without the TES indications for MRIs all had normal MRI scans.