Pituitary Adenoma
Conditions
Keywords
Nonfunctioning Pituitary Adenoma, Dopamine Agonist, Dopamine D2 Receptors, PET-MR
Brief summary
To study the in vivo expression of dopamine D2 receptors in nonfunctioning pituitary adenoma and the predictive role of dopamine dopamine D2 receptors PET-MR imaging in the therapeutic effect of dopamine agonists（DA）.
Detailed description
Dopamine agonists are the first line therapy for prolactinoma,which are also effective in some cases of other subtypes of pituitary tumors. It had been showed that dopamine agonists inhibit prolactin secretion by binding to and activating dopamine D2 receptors. PET-MR combined MR images with PET function images is substantial to evaluate the expression of dopamine D2 receptors.The aim is to study the in vivo expression of dopamine D2 receptors in prolactinoma and the predictive role of dopamine D2 receptors PET-MR imaging in the therapeutic effect of dopamine agonists.
Interventions
DRUGDrug treatment
Subjects who show high expression of dopamine D2 receptors in PET-MR imaging will be treated with Cabergoline(CAB) tablets 2mg/week or bromocriptine(BC) tablets 7.5mg/ day.The pituitary hormone levels, tumor volume, visual acuity and visual field scale will be measured every 3 months. The medication will be stopped if failure to decrease tumor size and the subjects will be advised to surgical therapy.
OTHERSurgery
Subjects who show low expression of dopamine D2 receptors in PET-MR imaging will be treated with endoscopic transphenoidal pituitary surgery .
Sponsors
Xinqiao Hospital of Chongqing
First Hospital of China Medical University
Beijing Tiantan Hospital
First Affiliated Hospital of Wenzhou Medical University
First Affiliated Hospital of Fujian Medical University
Peking Union Medical College Hospital
Huashan Hospital
Chinese PLA General Hospital
Zhebao Wu
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
1. Normal serum pituitary hormone levels or mild increase of serum prolactin. 2. Enhanced MRI shows a pituitary tumor and tumor diameter\>1cm. 3. Aged between 18 and 65 years old, either sex. 4. Karnofsky performance status ≥ 70. 5. The patient has signed the informed consent.
Exclusion criteria
1. Patients concomitantly taking the psychotropic drugs. 2. Patients with parkinson disease and is taking dopaminergic agents. 3. Patients with pituitary adenoma who received Gamma knife treatment. 4. Pregnant or lactating women. 5. Patients with poor compliance, who cannot implement the program strictly. 6. History of allergic reactions attributed to compounds of similar chemical or biologic composition to cabergoline. 7. Patients with claustrophobia. -
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline on tumor volume | Up to 6 months] | Change from baseline on tumor volume measured by enhanced pituitary Magnetic Resonance Imaging（MRI）. Record the tumor volume from enhanced pituitary MRI on every 3 month follow-up visit. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline of visual acuity | Up to 6 months | Record the Visual acuity on every 3 month follow-up visit. |
| Change from visual field scale | Up to 6 months | 2.Record the Visual field scale on every 3 month follow-up visit, 0 = normal, no vision loss; 1 = one quadrant vision loss; 2 = two quadrants of vision loss; 3 = three quadrants of vision loss; 4 = four quadrants of vision loss but retain a central tubular vision; 5 = blind |
Contacts
Primary ContactWeiting Gu, MD
Backup ContactZhebao Wu, Medical PhD
Outcome results
None listed