Congress of Neurological Surgeons Systematic Review and Evidence-Based Guidelines for the Role of Imaging for Patients With Functioning Pituitary Adenomas

BACKGROUND: Patients with functioning pituitary adenomas (FPA) present a diagnostic challenge with identification of microadenomas and/or invasion of the cavernous sinus. OBJECTIVE: The aim of this study was to provide evidence-based recommendations on the use of imaging to facilitate an accurate diagnosis. METHODS: PubMed and Embase were searched from the inception of the database to June 8, 2021, using search terms and search strategies to identify pertinent abstracts. These were then screened using published exclusion/inclusion criteria to identify full-text review articles. Evidence tables were constructed using data from full-text reviews, and recommendations were made. RESULTS: Of the total 8685 identified abstracts pertinent to this topic, 138 full articles met the eligibility criteria. Of these, 18 met the inclusion criteria and were included in the evidence tables. Class III evidence supported 4 Level III recommendations for adult patients with FPA. CONCLUSION: This systematic review provides evidence-based recommendations to guide providers caring for adult patients with FPA when making decisions pertinent to imaging. The Congress of Neurological Surgeons will continue to pursue timely updates and to further improve the care of patients with diagnosis.