TABLE 1.

Publications on use of iMRI including endoscopic surgery for pituitary adenomas

Authors & Year	Surgical Approach	No. of Patients	Outcomes Measures	Hormone Outcomes	Main Finding	Limitations
Soneru et al., 201913	8 using endoscope + iMRI; 15 w/ microscope + iMRI (none w/ both)	85 studies (systematic review)	GTR; CSF leak	Not evaluated	Endoscope + iMRI achieve higher GTR rates than using microscope + iMRI, but no direct comparison could be performed; may have added benefit, but studies are too heterogeneous	Systematic review, no independent data; no direct comparison btwn microscope & endoscope; no endocrine outcomes evaluated
Staartjes et al., 201919	Endoscopic only	95 patients	Rate of conversion to GTR following iMRI	Not evaluated	iMRI has optimal benefit for Zurich grade I & II adenomas	No comparison btwn microscope & endoscope; no endocrine outcomes evaluated
Zhang et al., 201922	Endoscopic	133 patients (NFA only)	GTR; PFS	No details/nos. for status of preop deficits; no information on postop Dl	iMRI resulted in increased GTR rate from intraop to postop MRI	No comparison btwn microscope & endoscope; nonfunctioning only; minimal information on endocrine outcomes; postop complications not discussed
Hlaváč et al., 201915	Microscopic & endoscopic	111 (invasive—Knosp 3 or 4)	EOR; endocrine outcomes	New hormone deficits; hormone remission	iMRI may increase GTR rates in invasive pituitary adenomas, potentially w/ higher rates of endocrine deficit	Prior hormone deficits improvement not included; focuses on tumors w/ grade III+ CSI; limited secretory group
Zhang et al., 201721	Endoscopic	137	GTR before & after iMRI	New hormone deficits	iMRI increased the GTR rate from first to postop scans & identified intraop hematoma	Selection bias for use of iMRI; no size stratification; secretory hormone remission not included; improvement in prior hormone deficits NR; PFS NR
Pal’a et al., 201717	Microscopic & endoscopic	97	EOR; pituitary hormone status	New hormone deficits; hormone remission (limited)	Endoscopy resulted in higher rates of GTR & hormone preservation than microscopy; iMRI may be of benefit w/ endoscope for invasive tumors	Small sample size, limited representation; PFS NR; small secretory cohort, unable to make comparisons
García et al., 201714	Endoscopic	30	GTR compared w/ a historical cohort of endoscopic approach only	Hormone remission; new hormone deficits	Use of iMRI increased GTR rates in 20% of cases	Small sample size; no microscopic comparison; PFS NR; improvement in prior hormone deficit NR; small secretory cohort; short FU (10-mo avg)
Zaidi et al., 201620	Endoscopic	20	GTR before & after iMRI	Hormone remission; new hormone deficit	iMRI increased GTR in 20% of cases	Small sample size; selection bias for use of iMRI; short FU (avg 4.3 mos); PFS NR; improvement in hormone deficits NR
Serra et al., 201618	Endoscopic	50	EOR; hormone status	Hormone remission; new hormone deficit	iMRI increased EOR	Small sample size; PFS NR; improvement in hormone deficits NR
Sylvester et al.,20156	Endoscopic & microscopic	156	EOR; hormone status	Hormone remission	iMRI combined w/ endoscope increased EOR compared w/ microsurgery	Selection bias for use of iMRI; new anterior hormone deficits NR; improvement in hormone deficits NR
Netuka et al., 201116	Endoscopic	85	EOR	Not evaluated	iMRI increased EOR from iMRI to postop MRI	No hormone outcomes; no complications reported; no comparison group

Avg = average; FU = follow-up; NR = not reported.

This table reflects publications on the use of iMRI for the resection of pituitary adenomas, including series that report on use of the endoscopic approach. The outcome measures, particularly hormone outcomes, are variably reported.