{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T21:27:26Z","timestamp":1775251646185,"version":"3.50.1"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pituitary"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>The optimal management approach for presumed non-functioning pituitary microadenomas (microNFPAs) remains unclear. Our aim was to capture current UK practice and identify changes with time.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Two online surveys investigating clinicians\u2019 approaches were performed in 2009\u20132010 and 2021\u20132022 (advertised through Society for Endocrinology UK).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>150 and 214 clinicians participated in the 2021 and 2009 survey, respectively (response rates 31.2% and 35.4%, respectively). At baseline, 2021 survey respondents were more likely to measure IGF-1 (96.0% vs 74.1%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and morning cortisol (87.9% vs 62.6%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and less likely GH (26.2% vs 42.6% <jats:italic>p<\/jats:italic>\u2009=\u20090.002), 24\u00a0h urine free cortisol (3.4% vs 23.2%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001) or dynamically assess adrenal reserve (11.4% vs 30.4%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). 47.2% of clinicians in 2021 would reassess pituitary function annually until discharge (in absence of tumour growth\/symptoms). The 2021 survey respondents were more likely to stop imaging at or before 3\u00a0years (81.7% vs 44.3%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and at or before 5\u00a0years (86.6.% vs 72.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002), whilst 2009 survey respondents were more likely to continue imaging beyond 5\u00a0years (24% vs 7%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Responses on imaging frequency\/intervals showed notable variability in both surveys.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Diagnostic and management approaches for microNFPAs have evolved in the UK. Biochemical investigations are performed in accord with consensus guidelines, though many clinicians perform annual biochemical surveillance without tumour growth\/symptoms. A small number of clinicians request imaging beyond 5\u00a0years, but the frequency of imaging intervals until discharge remains variable. Robust evidence on the long-term natural history of microNFPAs is necessary to unify clinician approach.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s11102-022-01290-4","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T20:02:34Z","timestamp":1669406554000},"page":"94-104","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["UK practice on incidentally detected non-functioning pituitary microadenomas: analysis of two national surveys during a 12-year interval"],"prefix":"10.1007","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9801-0458","authenticated-orcid":false,"given":"Ross","family":"Hamblin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasios","family":"Fountas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miles","family":"Levy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4696-0643","authenticated-orcid":false,"given":"Niki","family":"Karavitaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"issue":"2","key":"1290_CR1","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1007\/s11102-018-0869-3","volume":"21","author":"G Ntali","year":"2018","unstructured":"Ntali G, Wass JA (2018) Epidemiology, clinical presentation and diagnosis of non-functioning pituitary adenomas. Pituitary 21(2):111\u2013118. https:\/\/doi.org\/10.1007\/s11102-018-0869-3","journal-title":"Pituitary"},{"issue":"3","key":"1290_CR2","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1111\/j.1365-2265.2009.03667.x","volume":"72","author":"A Fernandez","year":"2010","unstructured":"Fernandez A, Karavitaki N, Wass JA (2010) Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol (Oxf) 72(3):377\u2013382. https:\/\/doi.org\/10.1111\/j.1365-2265.2009.03667.x","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"5","key":"1290_CR3","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1016\/j.beem.2009.05.001","volume":"23","author":"ME Molitch","year":"2009","unstructured":"Molitch ME (2009) Pituitary incidentalomas. Best Pract Res Clin Endocrinol Metab 23(5):667\u2013675. https:\/\/doi.org\/10.1016\/j.beem.2009.05.001","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"10","key":"1290_CR4","doi-asserted-by":"publisher","first-page":"817","DOI":"10.7326\/0003-4819-120-10-199405150-00001","volume":"120","author":"WA Hall","year":"1994","unstructured":"Hall WA, Luciano MG, Doppman JL, Patronas NJ, Oldfield EH (1994) Pituitary magnetic resonance imaging in normal human volunteers: occult adenomas in the general population. Ann Intern Med 120(10):817\u2013820. https:\/\/doi.org\/10.7326\/0003-4819-120-10-199405150-00001","journal-title":"Ann Intern Med"},{"issue":"4","key":"1290_CR5","first-page":"675","volume":"15","author":"BW Chong","year":"1994","unstructured":"Chong BW, Kucharczyk W, Singer W, George S (1994) Pituitary gland MR: a comparative study of healthy volunteers and patients with microadenomas. AJNR Am J Neuroradiol 15(4):675\u2013679","journal-title":"AJNR Am J Neuroradiol"},{"issue":"9","key":"1290_CR6","doi-asserted-by":"publisher","first-page":"4268","DOI":"10.1210\/jc.2010-0537","volume":"95","author":"A Raappana","year":"2010","unstructured":"Raappana A, Koivukangas J, Ebeling T, Piril\u00e4 T (2010) Incidence of pituitary adenomas in Northern Finland in 1992\u20132007. J Clin Endocrinol Metab 95(9):4268\u20134275. https:\/\/doi.org\/10.1210\/jc.2010-0537","journal-title":"J Clin Endocrinol Metab"},{"key":"1290_CR7","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/j.wneu.2021.11.079","volume":"158","author":"G Watanabe","year":"2022","unstructured":"Watanabe G, Choi SY, Adamson DC (2022) Pituitary incidentalomas in the United States: a national database estimate. World Neurosurg 158:843\u2013855. https:\/\/doi.org\/10.1016\/j.wneu.2021.11.079","journal-title":"World Neurosurg"},{"issue":"2","key":"1290_CR8","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1001\/archinte.1995.00430020067008","volume":"155","author":"LE Donovan","year":"1995","unstructured":"Donovan LE, Corenblum B (1995) The natural history of the pituitary incidentaloma. Arch Intern Med 155(2):181\u2013183","journal-title":"Arch Intern Med"},{"issue":"2","key":"1290_CR9","doi-asserted-by":"publisher","first-page":"172","DOI":"10.1111\/j.1742-1241.2010.02537.x","volume":"65","author":"P Anagnostis","year":"2011","unstructured":"Anagnostis P, Adamidou F, Polyzos SA, Efstathiadou Z, Panagiotou A, Kita M (2011) Pituitary incidentalomas: a single-centre experience. Int J Clin Pract 65(2):172\u2013177. https:\/\/doi.org\/10.1111\/j.1742-1241.2010.02537.x","journal-title":"Int J Clin Pract"},{"issue":"20","key":"1290_CR10","doi-asserted-by":"publisher","first-page":"2772","DOI":"10.1001\/jama.1990.03440200076026","volume":"263","author":"M Reincke","year":"1990","unstructured":"Reincke M, Allolio B, Saeger W, Menzel J, Winkelmann W (1990) The \u201cincidentaloma\u201d of the pituitary gland. Is neurosurgery required? JAMA 263(20):2772\u20132776","journal-title":"JAMA"},{"issue":"6","key":"1290_CR11","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1111\/j.1365-2265.2007.02990.x","volume":"67","author":"N Karavitaki","year":"2007","unstructured":"Karavitaki N, Collison K, Halliday J et al (2007) What is the natural history of nonoperated nonfunctioning pituitary adenomas? Clin Endocrinol (Oxf) 67(6):938\u2013943. https:\/\/doi.org\/10.1111\/j.1365-2265.2007.02990.x","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"2","key":"1290_CR12","doi-asserted-by":"publisher","first-page":"500","DOI":"10.3171\/2018.4.Jns172148","volume":"131","author":"JH Kim","year":"2019","unstructured":"Kim JH, Dho Y-S, Kim YH et al (2019) Developing an optimal follow-up strategy based on the natural history of nonfunctioning pituitary adenomas. J Neurosurg 131(2):500\u2013506. https:\/\/doi.org\/10.3171\/2018.4.Jns172148","journal-title":"J Neurosurg"},{"issue":"2","key":"1290_CR13","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1111\/cen.12879","volume":"84","author":"N Lenders","year":"2016","unstructured":"Lenders N, Ikeuchi S, Russell AW, Ho KK, Prins JB, Inder WJ (2016) Longitudinal evaluation of the natural history of conservatively managed nonfunctioning pituitary adenomas. Clin Endocrinol (Oxf) 84(2):222\u2013228. https:\/\/doi.org\/10.1111\/cen.12879","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"6","key":"1290_CR14","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1111\/cen.12860","volume":"83","author":"AH Sam","year":"2015","unstructured":"Sam AH, Shah S, Saleh K et al (2015) Clinical outcomes in patients with nonfunctioning pituitary adenomas managed conservatively. Clin Endocrinol (Oxf) 83(6):861\u2013865. https:\/\/doi.org\/10.1111\/cen.12860","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"2","key":"1290_CR15","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1111\/j.1365-2265.2008.03201.x","volume":"69","author":"KC Yuen","year":"2008","unstructured":"Yuen KC, Cook DM, Sahasranam P et al (2008) Prevalence of GH and other anterior pituitary hormone deficiencies in adults with nonsecreting pituitary microadenomas and normal serum IGF-1 levels. Clin Endocrinol (Oxf) 69(2):292\u2013298. https:\/\/doi.org\/10.1111\/j.1365-2265.2008.03201.x","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"3","key":"1290_CR16","doi-asserted-by":"publisher","first-page":"e1231","DOI":"10.1210\/clinem\/dgab748","volume":"107","author":"AJ Han","year":"2022","unstructured":"Han AJ, Varlamov EV, Fleseriu M (2022) Nonfunctioning pituitary microadenomas: should imaging interval be extended? A large single-center cohort study. J Clin Endocrinol Metab 107(3):e1231\u2013e1241. https:\/\/doi.org\/10.1210\/clinem\/dgab748","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"1290_CR17","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1046\/j.1365-2265.1999.00748.x","volume":"51","author":"J Feldkamp","year":"1999","unstructured":"Feldkamp J, Santen R, Harms E, Aulich A, M\u00f6dder U, Scherbaum WA (1999) Incidentally discovered pituitary lesions: high frequency of macroadenomas and hormone-secreting adenomas\u2014results of a prospective study. Clin Endocrinol (Oxf) 51(1):109\u2013113. https:\/\/doi.org\/10.1046\/j.1365-2265.1999.00748.x","journal-title":"Clin Endocrinol (Oxf)"},{"issue":"7\u20138","key":"1290_CR18","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1159\/000503256","volume":"110","author":"AS Tresoldi","year":"2020","unstructured":"Tresoldi AS, Carosi G, Betella N et al (2020) Clinically nonfunctioning pituitary incidentalomas: characteristics and natural history. Neuroendocrinology 110(7\u20138):595\u2013603. https:\/\/doi.org\/10.1159\/000503256","journal-title":"Neuroendocrinology"},{"issue":"2","key":"1290_CR19","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1530\/eje.0.1490123","volume":"149","author":"N Sanno","year":"2003","unstructured":"Sanno N, Oyama K, Tahara S, Teramoto A, Kato Y (2003) A survey of pituitary incidentaloma in Japan. Eur J Endocrinol 149(2):123\u2013127","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"1290_CR20","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1210\/jc.2010-1054","volume":"96","author":"MM Fern\u00e1ndez-Balsells","year":"2011","unstructured":"Fern\u00e1ndez-Balsells MM, Murad MH, Barwise A et al (2011) Natural history of nonfunctioning pituitary adenomas and incidentalomas: a systematic review and metaanalysis. J Clin Endocrinol Metab 96(4):905\u2013912. https:\/\/doi.org\/10.1210\/jc.2010-1054","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"1290_CR21","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1016\/s0889-8529(05)70125-0","volume":"29","author":"TA Howlett","year":"2000","unstructured":"Howlett TA, Como J, Aron DC (2000) Management of pituitary incidentalomas. A survey of British and American endocrinologists. Endocrinol Metab Clin North Am 29(1):223\u2013230. https:\/\/doi.org\/10.1016\/s0889-8529(05)70125-0","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"4","key":"1290_CR22","doi-asserted-by":"publisher","first-page":"894","DOI":"10.1210\/jc.2010-1048","volume":"96","author":"PU Freda","year":"2011","unstructured":"Freda PU, Beckers AM, Katznelson L et al (2011) Pituitary incidentaloma: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 96(4):894\u2013904. https:\/\/doi.org\/10.1210\/jc.2010-1048","journal-title":"J Clin Endocrinol Metab"},{"issue":"3","key":"1290_CR23","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.ando.2015.04.004","volume":"76","author":"F Galland","year":"2015","unstructured":"Galland F, Vantyghem M-C, Cazabat L et al (2015) Management of nonfunctioning pituitary incidentaloma. Ann Endocrinol 76(3):191\u2013200. https:\/\/doi.org\/10.1016\/j.ando.2015.04.004","journal-title":"Ann Endocrinol"},{"issue":"3","key":"1290_CR24","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1055\/a-1373-4087","volume":"129","author":"T Deutschbein","year":"2021","unstructured":"Deutschbein T, Jaursch-Hancke C, Knappe UJ et al (2021) First German guideline on diagnostics and therapy of clinically non-functioning pituitary tumors. Exp Clin Endocrinol Diabetes 129(3):250\u2013264. https:\/\/doi.org\/10.1055\/a-1373-4087","journal-title":"Exp Clin Endocrinol Diabetes"},{"issue":"2","key":"1290_CR25","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1007\/s11102-017-0856-0","volume":"21","author":"W Huang","year":"2018","unstructured":"Huang W, Molitch ME (2018) Management of nonfunctioning pituitary adenomas (NFAs): observation. Pituitary 21(2):162\u2013167. https:\/\/doi.org\/10.1007\/s11102-017-0856-0","journal-title":"Pituitary"},{"issue":"2","key":"1290_CR26","doi-asserted-by":"publisher","first-page":"101268","DOI":"10.1016\/j.beem.2019.04.002","volume":"33","author":"CL Boguszewski","year":"2019","unstructured":"Boguszewski CL, de Castro Musolino NR, Kasuki L (2019) Management of pituitary incidentaloma. Best Pract Res Clin Endocrinol Metab 33(2):101268. https:\/\/doi.org\/10.1016\/j.beem.2019.04.002","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"2","key":"1290_CR27","doi-asserted-by":"publisher","first-page":"101290","DOI":"10.1016\/j.beem.2019.101290","volume":"33","author":"P Chanson","year":"2019","unstructured":"Chanson P, Maiter D (2019) The epidemiology, diagnosis and treatment of prolactinomas: the old and the new. Best Pract Res Clin Endocrinol Metab 33(2):101290. https:\/\/doi.org\/10.1016\/j.beem.2019.101290","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"issue":"5","key":"1290_CR28","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1530\/eje-15-0189","volume":"173","author":"TT Agustsson","year":"2015","unstructured":"Agustsson TT, Baldvinsdottir T, Jonasson JG et al (2015) The epidemiology of pituitary adenomas in Iceland, 1955\u20132012: a nationwide population-based study. Eur J Endocrinol 173(5):655\u2013664. https:\/\/doi.org\/10.1530\/eje-15-0189","journal-title":"Eur J Endocrinol"},{"issue":"11","key":"1290_CR29","doi-asserted-by":"publisher","first-page":"3625","DOI":"10.1210\/jcem.82.11.4383","volume":"82","author":"JT King Jr","year":"1997","unstructured":"King JT Jr, Justice AC, Aron DC (1997) Management of incidental pituitary microadenomas: a cost-effectiveness analysis. J Clin Endocrinol Metab 82(11):3625\u20133632. https:\/\/doi.org\/10.1210\/jcem.82.11.4383","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"1290_CR30","doi-asserted-by":"publisher","first-page":"3933","DOI":"10.1210\/jc.2014-2700","volume":"99","author":"L Katznelson","year":"2014","unstructured":"Katznelson L, Laws ER Jr, Melmed S et al (2014) Acromegaly: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 99(11):3933\u20133951. https:\/\/doi.org\/10.1210\/jc.2014-2700","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"1290_CR31","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1007\/s11102-012-0454-0","volume":"16","author":"M Gruppetta","year":"2013","unstructured":"Gruppetta M, Mercieca C, Vassallo J (2013) Prevalence and incidence of pituitary adenomas: a population based study in Malta. Pituitary 16(4):545\u2013553. https:\/\/doi.org\/10.1007\/s11102-012-0454-0","journal-title":"Pituitary"},{"issue":"3","key":"1290_CR32","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1530\/eje-16-0117","volume":"175","author":"J Dal","year":"2016","unstructured":"Dal J, Feldt-Rasmussen U, Andersen M et al (2016) Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study. Eur J Endocrinol 175(3):181\u2013190. https:\/\/doi.org\/10.1530\/eje-16-0117","journal-title":"Eur J Endocrinol"},{"issue":"6","key":"1290_CR33","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1210\/clinem\/dgab069","volume":"106","author":"EC Coopmans","year":"2021","unstructured":"Coopmans EC, Postma MR, Wolters TLC et al (2021) Predictors for remission after transsphenoidal surgery in acromegaly: a Dutch Multicenter Study. J Clin Endocrinol Metab 106(6):1783\u20131792. https:\/\/doi.org\/10.1210\/clinem\/dgab069","journal-title":"J Clin Endocrinol Metab"},{"issue":"12","key":"1290_CR34","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1016\/s2213-8587(21)00235-7","volume":"9","author":"M Fleseriu","year":"2021","unstructured":"Fleseriu M, Auchus R, Bancos I et al (2021) Consensus on diagnosis and management of Cushing\u2019s disease: a guideline update. Lancet Diabetes Endocrinol 9(12):847\u2013875. https:\/\/doi.org\/10.1016\/s2213-8587(21)00235-7","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"5","key":"1290_CR35","doi-asserted-by":"publisher","first-page":"1526","DOI":"10.1210\/jc.2008-0125","volume":"93","author":"LK Nieman","year":"2008","unstructured":"Nieman LK, Biller BM, Findling JW et al (2008) The diagnosis of Cushing\u2019s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 93(5):1526\u20131540. https:\/\/doi.org\/10.1210\/jc.2008-0125","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"1290_CR36","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1530\/eje-14-0599","volume":"172","author":"A Toini","year":"2015","unstructured":"Toini A, Dolci A, Ferrante E et al (2015) Screening for ACTH-dependent hypercortisolism in patients affected with pituitary incidentaloma. Eur J Endocrinol 172(4):363\u2013369. https:\/\/doi.org\/10.1530\/eje-14-0599","journal-title":"Eur J Endocrinol"},{"issue":"3","key":"1290_CR37","doi-asserted-by":"publisher","first-page":"239","DOI":"10.1016\/j.ando.2015.04.002","volume":"76","author":"P Chanson","year":"2015","unstructured":"Chanson P, Raverot G, Castinetti F, Cortet-Rudelli C, Galland F, Salenave S (2015) Management of clinically non-functioning pituitary adenoma. Ann Endocrinol 76(3):239\u2013247. https:\/\/doi.org\/10.1016\/j.ando.2015.04.002","journal-title":"Ann Endocrinol"},{"issue":"11","key":"1290_CR38","doi-asserted-by":"publisher","first-page":"3888","DOI":"10.1210\/jc.2016-2118","volume":"101","author":"M Fleseriu","year":"2016","unstructured":"Fleseriu M, Hashim IA, Karavitaki N et al (2016) Hormonal replacement in hypopituitarism in adults: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 101(11):3888\u20133921. https:\/\/doi.org\/10.1210\/jc.2016-2118","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"1290_CR39","doi-asserted-by":"publisher","first-page":"104081","DOI":"10.1016\/j.lpm.2021.104081","volume":"50","author":"SM Constantinescu","year":"2021","unstructured":"Constantinescu SM, Maiter D (2021) Pituitary incidentaloma. Presse Med 50(4):104081. https:\/\/doi.org\/10.1016\/j.lpm.2021.104081","journal-title":"Presse Med"},{"issue":"11","key":"1290_CR40","doi-asserted-by":"publisher","first-page":"1445","DOI":"10.1530\/ec-21-0386","volume":"10","author":"R Al Argan","year":"2021","unstructured":"Al Argan R, Ramadhan A, Agnihotram RV, Chankowsky J, Rivera J (2021) Baseline MRI findings as predictors of hypopituitarism in patients with non-functioning pituitary adenomas. Endocr Connect 10(11):1445\u20131454. https:\/\/doi.org\/10.1530\/ec-21-0386","journal-title":"Endocr Connect"},{"issue":"1","key":"1290_CR41","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1530\/eje-16-0041","volume":"175","author":"SA Imran","year":"2016","unstructured":"Imran SA, Yip C-E, Papneja N et al (2016) Analysis and natural history of pituitary incidentalomas. Eur J Endocrinol 175(1):1\u20139. https:\/\/doi.org\/10.1530\/eje-16-0041","journal-title":"Eur J Endocrinol"}],"container-title":["Pituitary"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11102-022-01290-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11102-022-01290-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11102-022-01290-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T13:11:59Z","timestamp":1675948319000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11102-022-01290-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,25]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,2]]}},"alternative-id":["1290"],"URL":"https:\/\/doi.org\/10.1007\/s11102-022-01290-4","relation":{},"ISSN":["1386-341X","1573-7403"],"issn-type":[{"value":"1386-341X","type":"print"},{"value":"1573-7403","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,25]]},"assertion":[{"value":"6 November 2022","order":1,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 November 2022","order":2,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"RH, AF, ML and NK declare no competing interests related to this paper.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}