World Neurosurgery: X · Published 2026-05-27 · DOI 10.1016/j.wnsx.2026.100601
Sudharsan Madhavan, Beng Ti Ang, Dawn Shao Ting Lim, Si Wei Kheok, Ling Ling Chan, Chen Pong Wong, Robert Chun Chen
Pituitary Adenomas (PA) are one of the most commonly encountered sellar lesions on imaging. Although most neuroradiologists are aware of the diagnostic features of PA, there is well-documented variability in reporting styles. Furthermore, there is paucity of standardized reporting items which surgeons deem useful from pre-operative pituitary imaging. This clinico-radiological narrative review will consolidate empirical evidence to familiarize radiologists with imaging characteristics crucial for successful planning and execution of pituitary surgery. A standardized synoptic reporting template for PA imaging is suggested for neuroradiologists to incorporate into their practice.A brief review of standard imaging technique will be presented. The importance of inherent tumor characteristics such as size, morphology, and consistency have important operative implications. PA relationship to adjacent structures such as the native pituitary gland, planum sphenoidale, optic chiasm and cavernous sinus may alter surgery and have post-operative prognostic ramifications. Finally, we review the pertinent anatomical features inclusive of the inter-carotid distance, native sphenoid sinus anatomy and pneumatization pattern that can directly affect intra-operative management.Neuroradiologists armed with essential pre-requisite knowledge when reporting PAs will aid surgeons and endocrinologists make management decisions, plan and execute pituitary surgery and provide appropriate post-operative care.
Abstract from DOAJ. Public domain (CC0 1.0).
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Madhavan, S., Ang, B., Lim, D., et al. (2026). Pre-operative imaging assessment of pituitary adenomas: What the radiologist needs to know. World Neurosurgery: X. https://doi.org/10.1016/j.wnsx.2026.100601