Negative Pituitary MRI Findings in Cushing's Disease Do Not Lead to Inferior Rates of Long-Term Remission Following Transsphenoidal Surgery—A Single-Center Experience.

The article discusses the outcomes of transsphenoidal surgery (TSS) in patients with Cushing's disease (CD) who have negative MRI findings compared to those with positive MRI findings. The study found that while short-term remission rates were lower in patients with negative MRI findings, long-term remission rates and persistent disease rates were similar between the two groups. Factors predicting long-term remission included pre- and postoperative cortisol levels, extent of resection, and cavernous sinus invasion, rather than histological confirmation or positive MRI findings. The study suggests that surgery can induce long-term remission even in the absence of histological confirmation or positive MRI findings, possibly due to postoperative ischemic necrosis of the residual adenoma. [Extracted from the article]