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11C-methionine PET aids localization of microprolactinomas in patients with intolerance or resistance to dopamine agonist therapy.
Bashari, W A; van der Meulen, M; MacFarlane, J; Gillett, D; Senanayake, R; Serban, L; Powlson, A S; Brooke, A M; Scoffings, D J; Jones, J; O'Donovan, D G; Tysome, J; Santarius, T; Donnelly, N; Boros, I; Aigbirhio, F; Jefferies, S; Cheow, H K; Mendichovszky, I A; Kolias, A G; Mannion, R; Koulouri, O; Gurnell, M.
Afiliação
  • Bashari WA; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • van der Meulen M; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • MacFarlane J; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Gillett D; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Senanayake R; Department of Nuclear Medicine, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Serban L; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Powlson AS; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Brooke AM; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Scoffings DJ; Macleod Diabetes and Endocrine Centre, Royal Devon and Exeter Hospital, Exeter, UK.
  • Jones J; Department of Radiology, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • O'Donovan DG; Department of Radiology, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Tysome J; Department of Neuropathology, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Santarius T; Department of Otolaryngology, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Donnelly N; Department of Neurosurgery, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Boros I; Department of Otolaryngology, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Aigbirhio F; Wolfson Brain Imaging Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Jefferies S; Wolfson Brain Imaging Centre, University of Cambridge, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Cheow HK; Department of Oncology, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Mendichovszky IA; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Kolias AG; Department of Nuclear Medicine, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Mannion R; Department of Radiology, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Koulouri O; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Gurnell M; Department of Nuclear Medicine, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
Pituitary ; 25(4): 573-586, 2022 Aug.
Article em En | MEDLINE | ID: mdl-35608811
ABSTRACT

PURPOSE:

To assess the potential for 11C-methionine PET (Met-PET) coregistered with volumetric magnetic resonance imaging (Met-PET/MRCR) to inform clinical decision making in patients with poorly visualized or occult microprolactinomas and dopamine agonist intolerance or resistance. PATIENTS AND

METHODS:

Thirteen patients with pituitary microprolactinomas, and who were intolerant (n = 11) or resistant (n = 2) to dopamine agonist therapy, were referred to our specialist pituitary centre for Met-PET/MRCR between 2016 and 2020. All patients had persistent hyperprolactinemia and were being considered for surgical intervention, but standard clinical MRI had shown either no visible adenoma or equivocal appearances.

RESULTS:

In all 13 patients Met-PET/MRCR demonstrated a single focus of avid tracer uptake. This was localized either to the right or left side of the sella in 12 subjects. In one patient, who had previously undergone surgery for a left-sided adenoma, recurrent tumor was unexpectedly identified in the left cavernous sinus. Five patients underwent endoscopic transsphenoidal selective adenomectomy, with subsequent complete remission of hyperprolactinaemia and normalization of other pituitary function; three patients are awaiting surgery. In the patient with inoperable cavernous sinus disease PET-guided stereotactic radiosurgery (SRS) was performed with subsequent near-normalization of serum prolactin. Two patients elected for a further trial of medical therapy, while two declined surgery or radiotherapy and chose to remain off medical treatment.

CONCLUSIONS:

In patients with dopamine agonist intolerance or resistance, and indeterminate pituitary MRI, molecular (functional) imaging with Met-PET/MRCR can allow precise localization of a microprolactinoma to facilitate selective surgical adenomectomy or SRS.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Hipofisárias / Hiperprolactinemia / Prolactinoma / Adenoma Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Revista: Pituitary Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Reino Unido
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Neoplasias Hipofisárias / Hiperprolactinemia / Prolactinoma / Adenoma Tipo de estudo: Prognostic_studies Limite: Humans Idioma: En Revista: Pituitary Assunto da revista: ENDOCRINOLOGIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Reino Unido