title: The case of Cushing's disease imaging by SPECT examination without manifestation of pituitary adenoma in MRI examination.
abstract: BACKGROUND
  The aim of our study was to evaluate the possibility of imaging the pathological accumulation of (99m)Tc-MIBI in the pituitary gland in patients with Cushing's disease when MRI examination does not show microadenomas.
  
  
  METHODS
  Cushing's disease was diagnosed in a 27 year old male on the basis of clinical and biochemical findings. The blood cortisol level of the patient was elevated (the average level was 47 ug/dl) and it showed no changeability of day and night rhythm.
  
  
  RESULTS
  In the patient with Cushing's disease, during the SPECT examination, an increased accumulation of (99m)Tc-MIBI in the pituitary gland was noticed. MRI scanning was negative.
  
  
  CONCLUSIONS
  Single photon emission computed tomography using (99m)Tc-MIBI is a useful and sensitive means of pituitary gland microadenoma detection in patients with Cushing's disease when microadenoma is not detected during MRI scanning and when the results of dexamethasone suppression test is positive.
authors.affiliation: Laboratory of Nuclear Medicine of the Department of Endocrinology and Diabetology of the Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Gierach
authors.forename: Joanna
authors.initials: J
authors.lastname: Pufal
authors.forename: Stanisław
authors.initials: S
authors.lastname: Pilecki
authors.forename: Roman
authors.initials: R
authors.lastname: Junik
mesh_terms: D000236:Adenoma / Q000175:diagnosis*; D000328:Adult; D003480:Cushing Syndrome / Q000175:diagnosis*; D005188:False Negative Reactions; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010911:Pituitary Neoplasms / Q000175:diagnosis*; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi