Clinical usefulness of coregistered 11C-methionine positron emission tomography/3-T magnetic resonance imaging at the follow-up of acromegaly.
OBJECTIVE
This study sought to characterize the utility of coregistered 11C-methionine positron emission tomography (MET-PET) with 3-T magnetic resonance imaging (3T MRI) in the diagnosis and follow-up of pituitary adenomas in patients with acromegaly and to compare MET-PET and 18F-fluorodeoxyglucose emission tomography (FDG-PET) for the evaluation of active or recurrent disease.


METHODS
This is a prospective observational study. It included a total of 17 patients, 6 patients with a new diagnosis of acromegaly and 11 patients who had previously undergone resection of a confirmed growth hormone-secreting adenoma. The study protocol consisted of preoperative and postoperative evaluation with 3T MRI, and both MET-PET and FDG-PET. Coregistration of 3T MRI/MET-PET was accomplished.


RESULTS
In all patients who underwent preoperative imaging, MET-PET demonstrated increased uptake coincident with location of the pituitary lesion on 3T MRI. In the postoperative group, the coregistered 3T MRI/MET-PET demonstrated evidence of residual tumor in all patients with active disease. MET-PET sensitivity was 86% and specificity was 86% for the diagnosis of recurrence.


CONCLUSIONS
MET-PET is a sensitive technique for diagnosing persistent acromegaly, and its coregistration with 3T MRI has demonstrated a better definition of the interface, extension, and location of the lesion in the management of active postoperative acromegaly.
Department of Neurosurgery, Hospital Quiron, Murcia, Spain. Electronic address: endoneurocirugia@rodriguezbarcelo.es.
Sandra
S
Rodriguez-Barcelo
Molecular Imaging Unit, CIMES-General Foundation of the University of Malaga, Malaga, Spain.
Antonio
A
Gutierrez-Cardo
Department of Neurosurgery, Carlos Haya University Hospital, Malaga, Spain.
Miguel
M
Dominguez-Paez
Department of Neurosurgery, Carlos Haya University Hospital, Malaga, Spain.
Juan
J
Medina-Imbroda
Department of Neurosurgery, Carlos Haya University Hospital, Malaga, Spain.
Lorena
L
Romero-Moreno
Department of Neurosurgery, Carlos Haya University Hospital, Malaga, Spain.
Miguel
M
Arraez-Sanchez
D000172:Acromegaly / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D002250:Carbon Radioisotopes; D015331:Cohort Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008715:Methionine; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D059906:Neuroimaging / Q000379:methods*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D016896:Treatment Outcome
D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D008715:Methionine
3T MRI; Acromegaly; Methionine; PET; Pituitary adenoma