Criteria

Biochemical criteria

Biochemical criteria for diagnosis of acromegaly is based on elevated age- and sex-matched plasma insulin-like growth factor 1 (IGF-1) in serum and absence of growth hormone suppression after an oral glucose load.[4]​ The cutoff of the GH nadir is <0.4 to 1 micrograms/L (depending on the assay used).[4]​ 

IGF-1 and GH levels are well correlated at GH levels <20 micrograms/L, but IGF-1 levels plateau when serum GH increases above that level.[21]

Imaging

Invasiveness of the pituitary adenoma is judged according to:[22]

  • Pituitary tumor volume

  • Suprasellar extension and compression of neural structures

  • Invasion of sphenoid bone and cavernous sinuses (Knosp grading 1 to 4).[23]

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