Preoperative planning of patients with pituitary tumors (adenomas) according to neuroimaging data

Abstract

The task of any neurosurgery for a tumor removal is the safest possible resection with minimal complications. For its implementation, it is of great importance to carry out preoperative planning using modern neuroimaging methods (MRI, MSCT, PET). It includes imaging of topographic and anatomical features of the area of interest, which may vary depending on the direction of tumor growth. Neuroimaging data allows assessing the properties of the tumor (size, spread, density, degree of vascularization) in a particular patient at the preoperative stage. For the procedure of neuro-radiosurgery treatment, a dosimetric plan is additionally created, which should be as selective and conformal as possible, taking into account the critical structures located nearby. Aim of the study. Based on our own research and literature data, to analyze and demonstrate the most informative neuroimaging methods when planning neurosurgery and neuro-radiosurgery interventions that will ensure safe and, if possible, radical treatment of pituitary adenomas. Materials and methods. The analysis included 29 foreign and 9 Russian scientific sources devoted to the study of the possibilities of MRI, CT, and PET in the diagnosis of pituitary adenomas, from the perspective of modern neuroimaging capabilities. The work is illustrated with images of the studied area obtained during the planning of neurosurgery or neuro-radiosurgery treatment. The analysis of our own observations based on neuroimaging data in 280 patients was carried out. Results. Based on the analysis of literary sources, the modern possibilities of neuroimaging in the planning of neurosurgeries and neuro-radiosurgeries are demonstrated. Optimal neuroimaging techniques have been determined to assess the anatomical features of the sellar region and the properties of the tumor, allowing to increase the effectiveness of preoperative planning in each specific case.