Abstract
BackgroundThis study aimed to assess the clinical usefulness of 13N-ammonia and 11C- Methionine (MET) positron emission tomography (PET)/ computed tomography (CT) in the differentiation of residual/recurrent pituitary adenoma (RPA) from the pituitary gland remnant (PGR) after trans-sphenoidal adenomectomy.MethodsBetween June 2012 and December 2019, a total of 19 patients with a history of trans-sphenoidal adenomectomy before PET/CT scans and histological confirmation of RPA after additional surgery in our hospital were enrolled in this study. Images were interpreted by visual evaluation and semi-quantitative analysis. In semi-quantitative analysis, the maximum standard uptake value (SUVmax) of the target and gray matter was measured and the target uptake/gray matter uptake (T/G) ratio was calculated.ResultsThe T/G ratios of 13N-ammonia were significantly higher in PGR than RPA (1.58 ± 0.69 vs 0.63 ± 1.37, P < 0.001), whereas the T/G ratios of 11C-MET were obviously lower in PGR than RPA (0.78 ± 0.35 vs 2.17 ± 0.54, P < 0.001). Using the canonical discriminant analysis, we calculated the predicted accuracy of RPA (100%), PGR (92.9%), and the overall predicted accuracy (96.43%).ConclusionsThe combination of 13N-ammonia and 11C-MET PET/CT is valuable in the differentiation of RPA from PGR after trans-sphenoidal adenomectomy.
Highlights
This study aimed to assess the clinical usefulness of 13N-ammonia and 11C- Methionine (MET) positron emission tomography (PET)/ computed tomography (CT) in the differentiation of residual/recurrent pituitary adenoma (RPA) from the pituitary gland remnant (PGR) after trans-sphenoidal adenomectomy
The main uptake mechanism is as follows: (1) metabolic trapping of 13N-ammonia in pituitary tissue is related to the glutamine synthetase pathway (2) 13N-ammonia is a good indicator of pituitary tissue blood flow
Patients We retrospectively reviewed the data of suspected RPA patients who underwent 13N-ammonia and 11CMET PET/CT scans in our center between June 2012 and December 2019
Summary
This study aimed to assess the clinical usefulness of 13N-ammonia and 11C- Methionine (MET) positron emission tomography (PET)/ computed tomography (CT) in the differentiation of residual/recurrent pituitary adenoma (RPA) from the pituitary gland remnant (PGR) after trans-sphenoidal adenomectomy. The main treatment for primary pituitary adenomas is trans-sphenoidal surgery and residual/recurrent pituitary adenoma (RPA) can be seen in many patients [1,2,3]. Methionine (MET), a substrate for 11C labeling to trace increased protein synthesis, is a promising positron emission tomography (PET) tracer for the diagnosis of pituitary adenomas [7,8,9]. The purpose of this study was to retrospectively assess the usefulness of 13N-ammonia and 11C-MET PET/ computed tomography (CT) in the differentiation of RPA from PGR after trans-sphenoidal adenomectomy
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