Serial pituitary MRI and bone age radiology. Upper panel shows serial bone age X-rays. (A) At diagnosis chronological age (CA) 5.2 years, bone age (BA) 6.9 years. (B) At the start of pegvisomant treatment CA 12.3 years, BA 13.5 years. (C) Stable on pegvisomant, BA advancement resolved CA 14.8 years, BA 15 years. (D) Linear growth had resumed CA 16.6 years, BA 16 years. (E) At final height CA 18 years, BA 17.6 years (ie, mature). Lower panel: 4 of 10 serial pituitary MRI scans. All demonstrate slightly bulky but not enlarged pituitary of homogenous texture and enhancement; appearance and size and unchanged throughout the 13-year period. Sagittal T1-weighted images with gadolinium contrast (F) at diagnosis, (G) at the start of pegvisomant treatment at CA 12.3 years, (H) 2.3 years after pegvisomant treatment started, (J) 5.8 years after pegvisomant treatment started; (K) at CA 18 years.