Selective resection of cushing microadenoma guided by preoperative hybrid 18-fluoroethyl-L-tyrosine and 11-C-methionine PET/MRI
Autor: | Mirjam Christ-Crain, Freimut D. Juengling, Sven Berkmann, Beat Mueller, Egbert U. Nitzsche, Luigi Mariani, Michel Roethlisberger |
---|---|
Rok vydání: | 2021 |
Předmět: |
Adenoma
Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Context (language use) Cohort Studies 03 medical and health sciences Methionine 0302 clinical medicine Endocrinology Humans Medicine Pathological Retrospective Studies Transsphenoidal surgery medicine.diagnostic_test Brain Neoplasms business.industry Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging Exact test Positron-Emission Tomography Mann–Whitney U test Tyrosine Tomography business Nuclear medicine 030217 neurology & neurosurgery |
Zdroj: | Pituitary. 24:878-886 |
ISSN: | 1573-7403 1386-341X |
Popis: | 11-C-methionine (MET)-positron emission tomography (PET) as an adjunct to magnetic resonance imaging (MRI) has been proposed as a suitable molecular imaging modality for localizing pituitary adenomas in Cushing’s disease. 18-F-Fluoroethyl-L-tyrosine (FET)-PET, which is more widely available has not yet been reported in this context. Retrospective double-center cohort study on 15 patients who underwent transsphenoidal surgery for biochemically proven Cushing’s disease between 2011 and 2019. Preoperative MET-PET/MRI and/or FET-PET/MRI were compared with intraoperative and histopathological examinations using the Mann Whitney U test and the Fisher’s Exact test, along with positive predictive value calculations. Fifteen patients were included, with a mean age of 47.2 (18–69) years. Six patients received either a MET-PET/MRI or a FET-PET/MRI and 3 patients both exams, respectively. 67% of the tumors were detected by MRI (MET-PET-group [56%]; FET-PET-group [78%]). All tumors were microadenomas with a mean adenoma volume of 0.19 cm3 (0.02–0.78), all of which displayed a circumscribed pathological FET- and/or MET-uptake. FET-PET/MRI results positively correlated with the localization of the tumor confirmed intraoperatively and histopathologically in all cases, resulting in a sensitivity and specificity of FET-PET/MRI for tumor localization of 100% (95% CI 66.37–100%). One MET-PET/MRI suggested a localization contralateral to the expected spot. The sensitivity and specificity of MET-PET for tumor localization hence was 89% (95% CI 51.75–99.72%). Preoperative hybrid FET-PET/MRI and MET-PET/MRI have a high predictive value in localizing corticotroph adenoma for selective adenomectomy in Cushing’s disease. |
Databáze: | OpenAIRE |
Externí odkaz: |