AUTHOR=Hong A Ram , Lee Miwoo , Lee Jung Hyun , Kim Jung Hee , Kim Yong Hwy , Choi Hyung Jin 

TITLE=Clinical Implication of Individually Tailored Segmentation Method for Distorted Hypothalamus in Craniopharyngioma

JOURNAL=Frontiers in Endocrinology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2021.763523

DOI=10.3389/fendo.2021.763523

ISSN=1664-2392

ABSTRACT=<sec><title>Objective</title><p>Several attempts have been done to capture damaged hypothalamus (HT) using volumetric measurements to predict the development of hypothalamic obesity in patients with craniopharyngioma (CP). This study was to develop a novel method of HT volume measurement and examine the associations between postoperative HT volume and clinical parameters in patients with CP.</p></sec><sec><title>Methods</title><p>We included 78 patients with adult-onset CP who underwent surgical resection. Postoperative HT volume was measured using T1- and T2-weighted magnetic resonance imaging (MRI) with a slice thickness of 3 mm, and corrected for temporal lobe volume. We collected data on pre- and postoperative body weights, which were measured at the time of HT volume measurements.</p></sec><sec><title>Results</title><p>The corrected postoperative HT volume measured using T1- and T2-weighted images was significantly correlated (<italic>r</italic>=0.51 [95% confidence interval (CI) 0.32 to 0.67], <italic>P</italic>&lt;0.01). However, HT volume was overestimated using T1-weighted images owing to obscured MR signal of the thalamus in patients with severe HT damage. Therefore, we used T2-weighted images to evaluate its clinical implications in 72 patients with available medical data. Postoperative HT volume was negatively associated with preoperative body weight and preoperative tumor volume (<italic>r</italic>=–0.25 [95% CI -0.45 to -0.04], <italic>P</italic>=0.04 and <italic>r</italic>=–0.26 [95% CI -0.40 to -0.15], <italic>P</italic>=0.03, respectively). In the subgroup analysis of CP patients who underwent primary surgery (<italic>n</italic>=56), pre- and postoperative body weights were negatively associated with HT volume (<italic>r</italic>=–0.30 [95% CI -0.53 to -0.03], <italic>P</italic>=0.03 and <italic>r</italic>=–0.29 [95% CI -0.53 to -0.02], <italic>P</italic>=0.03, respectively).</p></sec><sec><title>Conclusions</title><p>Adult-onset CP patients showed negative associations between postoperative HT volume and preoperative/postoperative body weight using a new method of HT volume measurement based on T2-weighted images.</p></sec>