Implementation of functional imaging using 11 C-methionine PET-CT co-registered with MRI for advanced surgical planning and decision making in prolactinoma surgery.

Autor: Bakker LEH; Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands. l.e.h.bakker@lumc.nl.; Center for Endocrine Tumors Leiden (CETL), Pituitary Center, Leiden University Medical Center, Leiden, The Netherlands. l.e.h.bakker@lumc.nl., Verstegen MJT; Center for Endocrine Tumors Leiden (CETL), Pituitary Center, Leiden University Medical Center, Leiden, The Netherlands.; Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands., Ghariq E; Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Verbist BM; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Schutte PJ; Center for Endocrine Tumors Leiden (CETL), Pituitary Center, Leiden University Medical Center, Leiden, The Netherlands.; Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands., Bashari WA; Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK., Kruit MC; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands., Pereira AM; Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands.; Center for Endocrine Tumors Leiden (CETL), Pituitary Center, Leiden University Medical Center, Leiden, The Netherlands., Gurnell M; Wellcome-MRC Institute of Metabolic Science, Addenbrooke's Hospital, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK., Biermasz NR; Division of Endocrinology, Department of Medicine, Leiden University Medical Center, Leiden, The Netherlands.; Center for Endocrine Tumors Leiden (CETL), Pituitary Center, Leiden University Medical Center, Leiden, The Netherlands., van Furth WR; Center for Endocrine Tumors Leiden (CETL), Pituitary Center, Leiden University Medical Center, Leiden, The Netherlands.; Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands., Bouda LMPA; Section of Nuclear Medicine, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Jazyk: angličtina
Zdroj: Pituitary [Pituitary] 2022 Aug; Vol. 25 (4), pp. 587-601. Date of Electronic Publication: 2022 May 26.
DOI: 10.1007/s11102-022-01230-2
Abstrakt: Purpose: To report the first experience of our multidisciplinary team with functional imaging using 11 C-methionine positron emission tomography-computed tomography ( 11 C-methionine PET-CT) co-registered with MRI (Met-PET/MRI CR ) in clinical decision making and surgical planning of patients with difficult to treat prolactinoma.
Methods: In eighteen patients with prolactinoma, referred to our tertiary referral centre because of intolerance or resistance for dopamine agonists (DA), Met-PET/MRI CR was used to aid decision-making regarding therapy.
Results: Met-PET/MRI CR was positive in 94% of the patients. MRI and Met-PET/MRI CR findings were completely concordant in five patients, partially concordant in nine patients, and non-concordant in four patients. In five patients Met-PET/MRI CR identified lesion(s) that were retrospectively also visible on MRI. Met-PET/MRI CR was false negative in one patient, with a cystic adenoma on conventional MRI. Thirteen patients underwent transsphenoidal surgery, with nine achieving full biochemical remission, two clinical improvement and near normalized prolactin levels, and one patient clinical improvement with significant tumour reduction. Hence, nearly all patients (94%) were considered to have a positive outcome. Permanent complication rate was low. Three patients continued DA, two patients have a wait and scan policy.
Conclusion: Met-PET/MRI CR can provide additional information to guide multidisciplinary preoperative and intraoperative decision making in selected cases of prolactinoma. This approach resulted in a high remission rate with a low rate of complications in our expert centre.
(© 2022. The Author(s).)
Databáze: MEDLINE
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