Article Figures & Data
Figures
- FIGURE 1.
A 31-y-old woman with high adrenocorticotropic hormone level (patient 1 in Table 1). (A–D) MR images showing equivocal lesion at right end of sella region (from left to right: T1-weighted coronal, T2-weighted coronal, and contrast-enhanced T1-weighted coronal and sagittal views). (E–H) 18F-FDG PET/MR images showing definitely avid lesion (arrows) at same region as on MR images (from left to right: coronal PET, coronal PET/MRI, sagittal PET, and sagittal PET/MRI). (I–L) 68Ga-DOTATATE PET/MR images showing lower uptake in lesion than in normal pituitary tissue (arrowhead) (from left to right: coronal PET, coronal PET/MRI, sagittal PET, and sagittal PET/MRI). Follow-up surgery confirmed presence of right-sided 6 × 5 × 5 mm functional pituitary microadenoma, and pathologic stains were adrenocorticotropic hormone–positive, luteinizing hormone–positive, and growth hormone–positive.
- FIGURE 2.
Use of 18F-FDG SUVmax (A) and 18F-FDG/68Ga-DOTATATE SUVmax ratio (B) ROC curves for differentiation of pituitary adenoma from normal pituitary tissue. Area under curve and standard error were 0.85 ± 0.05 for 18F-FDG and 0.94 ± 0.03 for 18F-FDG/68Ga-DOTATATE. Optimal diagnostic cutoff by ROC analysis was 3.88 and 1.04, respectively. Diagnostic performance was better with 18F-FDG/68Ga-DOTATATE than with 18F-FDG alone.
Tables
MRI result PET/MRI SUVmax Patient no. Age (y) Sex P/R Hormone level Half dose Full dose 18F-FDG 68Ga-DOTATATE Adenoma size (mm) Immunohistochemical staining result 1 31 F P ACTH↑, F↑ − + 7.56 2.83 6 × 5 × 5 ACTH+, GH+, LH+ 2 16 M P ACTH↑, F↑ − + 4.8 2.8 5 × 5 × 5 ACTH+, GH+ 3 26 F P ACTH↑, F↑ − − 3.1 2.09 8 × 3 × 3 ACTH+, GH+ 4 63 F P GH↑, IGF1↑ − − 10.21 5.23 7 × 5 × 5 ACTH+, GH+, LH+, PRL+ 5 38 F P ACTH↑, F↑ − − 4.81 1.24 5 × 4 × 3 ACTH+ 6 38 F P ACTH↑, F↑ − − 9.07 4.61 5 × 4 × 3 ACTH+ 7 16 M P ACTH↑, F↑ ± + 6.81 5.3 6 × 5 × 5 ACTH+, GH+, LH+ 8 28 F P ACTH↑, F↑ ± + 2.95 12.05 3 × 3 × 2 ACTH+, GH+, LH+ 9 63 M P ACTH↑, F↑ ± − 7.23 2.55 5 × 5 × 5 ACTH+, GH+, LH+ 10 26 M P ACTH↑, F↑ ± − 3.68 6.15 3 × 2 × 2 ACTH+, GH+, LH+ 11 17 M P ACTH↑, F↑ ± − 17.48 3.35 10 × 8 × 8 ACTH+, GH+ 12 50 F P ACTH↑, F↑ ± + 3.1 2.09 5 × 5 × 5 ACTH+, GH+, LH+ 13 38 M P ACTH↑, F↑ − − 9.69 2.28 5 × 3 × 3 ACTH+, GH+ 14 45 F P ACTH↑, F↑ − + 5.61 3.02 5 × 5 × 3 ACTH+, GH+, LH+ 15 20 F P ACTH↑, F↑ ± − 8.56 2.2 5 × 5 × 5 ACTH+, GH+, LH+ 16 16 M P ACTH↑, F↑ ± − 4.27 3.02 4 × 3 × 3 ACTH+, GH+ 17 20 F R ACTH↑, F↑ − + 5.58 5.38 5 × 5 × 5 ACTH+, GH+ 18 30 F R ACTH↑, F↑ − + 8.84 2.62 6 × 5 × 5 ACTH+, GH+ 19 25 F R ACTH↑, F↑ ± + 6.6 4.36 6 × 5 × 5 ACTH+ 20 31 F R ACTH↑, F↑ ± + 2.69 1.94 5 × 3 × 3 ACTH−, FSH+, GH+, LH+ 21 29 F R ACTH↑, F↑ ± + 5.4 3.83 5 × 5 × 5 ACTH+, GH+, LH+ 22 10 F R ACTH↑, F↑ − − 2.49 2.39 3 × 3 × 3 ACTH+, GH+, LH+ 23 45 F R ACTH↑, F↑ ± + 3.96 2.08 5 × 5 × 5 ACTH+, GH+ 24 35 F R ACTH↑, F↑ − − 13.3 2.35 5 × 5 × 5 ACTH+, GH+ 25 50 F R ACTH↑, F↑ − − 3.7 3.35 4 × 3 × 3 ACTH+ 26 41 F R ACTH↑, F↑ ± + 10.49 2.02 5 × 6 × 6 ACTH+, GH+ 27 32 M R ACTH↑, F↑ − + 3.52 2.81 5 × 5 × 4 ACTH+, GH+, LH+ 28 11 F P ACTH↑, F↑ − − 7.45 3.92 NA NA 29 51 M P ACTH↑, F↑ − + 6.33 2.17 NA NA 30 59 F P ACTH↑, F↑ ± − 4.23 2.15 NA NA 31 55 F R GH↑, IGF1↑ − − 5.24 3.31 NA NA 32 57 M R T4↑ − + 7.34 2.35 NA NA 33 30 F R GH↑, IGF1↑ − − 9.56 3.22 NA NA 34 34 F R ACTH↑, F↑ − − 8.28 2.13 NA NA 35 17 M R ACTH↑, F↑ − − 5.21 3.28 NA NA 36 39 F R ACTH↑, F↑ ± − 8.35 5.28 NA NA 37 35 F R ACTH↑, F↑ ± − 4.38 3.17 NA NA P = primary; R = recurrent; half dose = 0.05 mmol/kg dose of gadopentetate dimeglumine; full dose = 0.1 mmol/kg dose of gadopentetate dimeglumine; ACTH = adrenocorticotropic hormone; F = cortisol (compound F); GH = growth hormone; LH = luteinizing hormone; IGF1 = insulinlike growth factor 1; PRL = prolactin; FSH = follicle-stimulating hormone; NA = not available because patient accepted clinical follow-up or treatments other than surgery; T4 = thyroxine; + = positive; − = negative.
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