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PNA Medical Corner: MRI for Cushing’s
7T MRI for Cushing’s Disease: A Single Institutional Experience and Literature Review
PMID: 38365424 DOI: 10.3174/ajnr.A8209
Abstract
Background and purpose: Cushing disease is typically caused by a pituitary adenoma that frequently is small and challenging to detect on conventional MRI. High field strength 7T MRI can leverage increased signal-to-noise and contrast-to-noise ratios compared to lower-field strength MRI to help identify small pituitary lesions. We aim to describe our institutional experience with 7T MRI in patients with Cushing disease and perform a review of the literature.
Materials and methods: A retrospective analysis of 7T MRI findings in patients with pathology proven cases of Cushing disease from a single institution, followed by a review of the literature on 7T MRI for Cushing disease.
Results: Our institutional experience identified Cushing adenomas in 10/13 (76.9%) patients on 7T, however only 5/13 (38.5%) lesions were discrete. Overall, the imaging protocols used were heterogeneous in terms of contrast dose as well as type of post-contrast T1-weighted sequences (Dynamic, 2D vs 3D, and type of 3D sequence). From our institutional data, specific post-gadolinium T1-weighted sequences were helpful in identifying a surgical lesion as follows: Dynamic Contrast Enhanced 2/7 (28.6%), 2D FSE 4/8 (50%), 3D SPACE 5/6 (83.3%), and 3D MPRAGE 8/11 (72.7%). The literature review identified Cushing adenomas in 31/33 (93.9%) patients on 7T.
Conclusions: 7T MRI for pituitary lesion localization in Cushing disease is a new technique with imaging protocols that varied widely. Further comparative research is needed to identify the optimal imaging technique as well as to assess the benefit of 7T over lower-field strength MRI.
Abbreviations: MRI = Magnetic Resonance Imaging, CT = Computed Tomography, 7T = 7 Tesla, DCE = Dynamic Contrast Enhanced.
© 2024 by American Journal of Neuroradiology.
Featured News and Updates
News Articles December 2025
Pituitary story: Long road to diagnosis
A retired Methodist minister from Raleigh, North Carolina named Lib Campbell tells her pituitary story in an article on DailyAdvance.com. She struggled for many years before being diagnosed with a lesion on her pituitary. Read more: https://www.dailyadvance.com/opinion/editorial_columnists/lib-campbell-everyone-is-deserving-of-affordable-health-care-insurance/article_d8ba7dd4-0d19-5eff-80d6-97fa1b598855.html
Pituitary case study: Early signs of acromegaly
Cureus.com features a case study on a 35-year-old man who went to the emergency room for dizzy spells. He also suffered from night sweats, his face was changing progressively, he snored and stopped breathing while resting. Tests showed a pituitary tumor; doctors diagnosed him with acromegaly. Read more:
Pituitary story: Soccer teammates come to the aid of 12-year-old pituitary patient
An article in the Connaught Tribune follows the story of a young girls’ soccer team in Ireland that is raising money toward medical care for two of the young teammates. A 12-year-old girl named Aoife is battling a pituitary tumor, and her friend, 13-year-old Emma has been diagnosed with Langerhans cell histiocytosis. Read more: https://connachttribune.ie/football-community-unites-behind-young-team-mates-both-battling-serious-illness/
Study examines role of age, gender, and stress in pituitary lobe volume
A study featured in Nature.com looks at the way the posterior and anterior lobes of the pituitary change over time and show differences according to gender and stress level. Results show that older adults had a smaller anterior lobe and a larger posterior lobe. They also showed less stress. Women generally have a larger anterior lobe than men. Read more: https://www.nature.com/articles/s41598-025-26558-0
Research explores autism in children whose mothers suffer thyroid imbalance in pregnancy
An article in Science Daily looks at an Israeli study that found that mothers who experience thyroid hormone imbalance in pregnancy and go untreated have a higher risk of bearing children with autism. They recommend thyroid checks in pregnancy, as the risk decreases when the thyroid issue is treated. Read more: https://www.sciencedaily.com/releases/2025/11/251129053353.htm
Research Articles
Research Articles December 2025
Mapping the evolution of pediatric craniopharyngioma research: a bibliometric analysis.
Frome S, Dastagirzada Y, Kurland D, Wisoff J.Childs Nerv Syst. 2025 Nov 29;41(1):389. doi: 10.1007/s00381-025-07050-6.
The interdisciplinary management of craniopharyngioma – practice patterns, outcomes, and insights.
Haselmann J, Roohani S, Wasilewski D, Onken J, Capper D, Kaul D, Ehret F.BMC Cancer. 2025 Nov 28. doi: 10.1186/s12885-025-14991-3. Online ahead of print.
Pituitary Surgery
Training in endoscopic endonasal surgery: EANS young neurosurgeons committee survey.
Zoli M, Aldea C, Bauer M, Belo D, Drosos E, Jadoon S, Kaprovoy S, Lepic M, Lippa L, Mohme M, Motov S, Spiriev T, Stastna D, Stengel FC, Raffa G.Neurosurg Rev. 2025 Nov 28;49(1):31. doi: 10.1007/s10143-025-03962-8.
Joustra GE, van Rhee NF, den Heijer MC, Korsten-Meijer AGW, Feijen RA, Halmos GB, Kuijlen JMA, Vermeulen KM.Head Neck. 2025 Nov 28. doi: 10.1002/hed.70103. Online ahead of print.’
Cushing’s Disease
Hypercoagulability in Cushing’s syndrome: past, present, future.
Akirov A, Fleseriu M.Arch Endocrinol Metab. 2025 Nov 28;70(special 1):e250062. doi: 10.20945/2359-4292-2025-0095.Review.
Editor’s note: Dr Fleseriu is a longtime member of the PNA.
Lyu X, Liu J, Zhang D, Zhang X, Zhu H, Chen S, Lu L, Pan H.BMC Endocr Disord. 2025 Nov 27;25(1):275. doi: 10.1186/s12902-025-02092-y.
Hypophysitis
Primary hypophysitis: Classification review.
Turin CG, Kleinschmidt-DeMasters BK.J Neuropathol Exp Neurol. 2025 Nov 29:nlaf135. doi: 10.1093/jnen/nlaf135. Online ahead of print.41317043
Miquel L, Testud B, Albarel F, Appay R, Graillon T, Cuny T, Dufour H, Ebbo M, Brue T, Jarrot PA, Schleinitz N, Castinetti F.Nat Rev Endocrinol. 2025 Nov 27. doi: 10.1038/s41574-025-01200-1. Online ahead of print.
AI/ Machine Learning
Subba AB, Sunaniya AK, Mukherjee A.IEEE J Biomed Health Inform. 2025 Nov 27;PP. doi: 10.1109/JBHI.2025.3638154. Online ahead of print.
Hormonal health
Differential role of anterior and posterior pituitary lobes in healthy aging and perceived stress.
Doucet GE, Davis M, Mertens AT, Picci G.Sci Rep. 2025 Nov 27;15(1):42409. doi: 10.1038/s41598-025-26558-0.
Li G, Li M, Xie B, Chen J, Li S, Luo S, Mo C.World Neurosurg. 2025 Nov 28:124692. doi: 10.1016/j.wneu.2025.124692. Online ahead of print.
Large-scale comparison of two immunoassays for adrenocorticotropic hormone in human plasma.
Li Y, Louie JZ, Burgess TE, Bare LA, McPhaul MJ.Sci Rep. 2025 Nov 29. doi: 10.1038/s41598-025-26501-3. Online ahead of print.
Leibnitz S, Christ-Crain M, Atila C.Arch Endocrinol Metab. 2025 Nov 28;70(special 1):e20250259. doi: 10.20945/2359-4292-2025-0259.Review.
Diagnostic/Research
EndoCompass Project: Research Roadmap for Reproductive and Developmental Endocrinology.
Cools M, Krausz C, Juul A, Macut D, Andersen MS, Andersson AM, Andoniadou CL, Ahmed SF, Bakker J, Bashamboo A, Behre HM, Bonomi M, Busch AS, De Roo C, Dessens A, Fakhar-I-Adil M, Fanelli F, Fisher AD, Flück C, Gambineri A, Giwercman A, Gravholt CH, Hannema S, Heindryckx B, Hiort O, Hornig NC, Howard S, Ibáñez L, Jensen MB, Jørgensen N, Livadas S, Lucas-Herald A, Mastorakos G, Meriggiola MC, Ong K, Palibrk MO, Pignatelli D, Pitteloud N, Rajpert-De Meyts E, Rey R, Robeva R, Pozza C, Schlatt S, Spaggiari G, Tack L, Tena-Sempere M, Tournaye H, T’Sjoen G, Van Mello N, Vena W, Yildiz BO, de Zegher F.Horm Res Paediatr. 2025 Nov 27:1-23. doi: 10.1159/000549203. Online ahead of print.
EndoCompass and Neuroendocrine Tumor Endocrinology.
Castano JP, Dattani MT, Grozinsky-Glasberg S, Karavitaki N, Pavel ME, Andoniadou C, Alexandraki K, Capatina C, Cerbone M, Ferone D, Gan HW, Hofland J, Hofland L, Ibanez-Costa A, Ilie MD, Isidori AM, Korbonits M, Kos-Kudła B, Maghnie M, Mantovani G, Marazuela M, Raverot G, Scarpa A, Schilbach K, Theodoropoulou M, van Santen HM, Zatelli MC.Horm Res Paediatr. 2025 Nov 27:1-16. doi: 10.1159/000549145. Online ahead of print.
The FDA has approved NGENLA (somatrogon-ghla)
The FDA has approved NGENLA (somatrogon-ghla), a once-weekly, human growth hormone analog indicated for treatment of pediatric patients aged three years and older who have growth failure due to an inadequate secretion of endogenous growth hormone.
Count on your Xeris CareConnection™ Team for unparalleled Cushing’s Support
Cushing’s can be challenging, but there is support so patients can feel like themselves again. The main goal of treating Cushing’s is to get cortisol levels back to normal. This Pituitary Awareness Month, Xeris Pharmaceuticals® is highlighting the importance of one-on-one support for patients living with Cushing’s Syndrome and support for HCPs treating Cushing’s Syndrome.
Sign up to get dedicated support:
Patients: Sign up for support | Recorlev® (levoketoconazole)
HCP’s: Connect with Xeris support | RECORLEV® (levoketoconazole)
Have more questions? Call for more support at 1-844-444-RCLV (7258)
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