Is soft tissue radiology useful in acromegaly?

Twenty-six acromegalics had measurements of serum growth hormone (GH) levels during a glucose tolerance test, X rays of the heel for heel pad thickness, and of the hand for bone/soft tissue ratio. These measurements were performed before and between 2 and 7 years after treatment, which was by transethmoidal hypophysectomy, external irradiation or a combination of the two. Neither the heel pad thickness nor bone/soft tissue ratio correlated with the mean serum GH nor with each other before and after treatment. The nine patients who were assessed as showing a good clinical response to treatment showed a significantly greater fall in mean serum GH than the 17 patients who were assessed as unchanged or partial responders (40.1 +/- 20 mmu/l compared with 9.9 +/- 14.0 mmu/l, p = 0.02). However, there were no significant differences in changes of heel pad thickness nor bone/soft tissue ratio between these groups. It is concluded that these radiological measurements of soft tissues are unhelpful in the follow-up of acromegalic patients.