Clinical use of [ 18 F]fluoro-ethyl-L-tyrosine PET co-registered with MRI for localizing prolactinoma remnants.

Autor: van Trigt VR; Dept. of Medicine, Division of Endocrinology, Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, the Netherlands. v.r.van_trigt@lumc.nl., Bakker LEH; Dept. of Medicine, Division of Endocrinology, Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, the Netherlands., Lu H; Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands., Pelsma ICM; Dept. of Medicine, Division of Endocrinology, Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, the Netherlands., Verstegen MJT; Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands., van Furth WR; Department of Neurosurgery, Leiden University Medical Center, Leiden, The Netherlands., Pereira Arias-Bouda LM; Department of Radiology, Section of Nuclear Medicine, Leiden University Medical Center, Leiden, The Netherlands., Biermasz NR; Dept. of Medicine, Division of Endocrinology, Center for Endocrine Tumors Leiden, Leiden University Medical Center, Leiden, the Netherlands.
Jazyk: angličtina
Zdroj: Pituitary [Pituitary] 2024 Oct; Vol. 27 (5), pp. 614-624. Date of Electronic Publication: 2024 Jul 23.
DOI: 10.1007/s11102-024-01430-y
Abstrakt: Purpose: To assess the utility of [ 18 F]fluoroethyl-L-tyrosine PET co-registered with magnetic resonance imaging ([ 18 F]FET-PET/MRI CR ) in patients with difficult-to-localize prolactinoma to inform clinical decision-making and (surgical) treatment planning.
Methods: Retrospective cohort study of 17 consecutive patients with prolactinoma undergoing [ 18 F]FET-PET/MRI CR between October 2020 and September 2022 for either (1) additional information in case of difficult-to-visualize remnants after prior transsphenoidal surgery (TSS), or pharmacological treatment, or (2) radiological diagnosis in absence of a (clear) adenoma on diagnostic/post-treatment conventional MRI.
Results: [ 18 F]FET-PET/MRI CR identified a lesion in 14/17 patients, yet failed to identify active lesions in 2 patients with negative conventional MRI despite prolactin > 7.5 times upper limit of normal. [ 18 F]FET-PET/MRI CR results were inconclusive in 1 patient due to diffuse tracer uptake 10 weeks post-surgery. [ 18 F]FET-PET/MRI CR was completely concordant with a suspected lesion on conventional MRI in 10/17 patients, and partially concordant in 3/17 patients. New foci were identified in 4/17 patients. The [ 18 F]FET-PET/MRI CR conclusions influenced clinical shared decision-making in 15/17 patients, of whom 7 patients underwent TSS and 8 refrained from TSS. One patient underwent TSS despite negative [ 18 F]FET-PET/MRI CR , and one patient underwent additional imaging. Intraoperative findings corresponded with [ 18 F]FET-PET/MRI CR in 5/8 patients, and immunohistochemistry was positive in 5/8 patients. The treatment goal was achieved in 7/8 patients, and remission was achieved in 5/7 patients in whom total resection was considered feasible.
Conclusion: [ 18 F]FET-PET/MRI CR can be of added value in the preoperative decision-making process for selected patients with difficult-to-localize prolactinoma (remnants), or patients lacking a substrate on conventional MRI.
(© 2024. The Author(s).)
Databáze: MEDLINE
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