Sella imaging with MRI or CT is done to exclude a pituitary macroadenoma or other mass in men with any of the following: Age < 60 years with no other identified cause for hypogonadism Very low total testosterone levels (< 200 ng / dL [6.94 nmol / L]) Elevated prolactin levels Symptoms consistent with a pituitary tumor (eg, headache, visual symptoms) Also, if there are symptoms or signs of Cushing syndrome, 24-hour urine collection for free cortisol or a dexamethasone suppression test is done.