RT Journal Article
SR Electronic
T1 Using Molecular Imaging to Enhance Decision Making in the Management of Pituitary Adenomas
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 57S
OP 62S
DO 10.2967/jnumed.120.251546
VO 62
IS Supplement 2
A1 Waiel A. Bashari
A1 Russell Senanayake
A1 James MacFarlane
A1 Daniel Gillett
A1 Andrew S. Powlson
A1 Angelos Kolias
A1 Richard J. Mannion
A1 Olympia Koulouri
A1 Mark Gurnell
YR 2021
UL http://jnm.snmjournals.org/content/62/Supplement_2/57S.abstract
AB In most patients with suspected or confirmed pituitary adenomas (PAs), MRI, performed using T1- (with or without gadolinium enhancement) and T2-weighted sequences, provides sufficient information to guide effective clinical decision making. In other patients, additional MR sequences (e.g., gradient recalled echo, fluid-attenuation inversion recovery, MR elastography, or MR angiography) may be deployed to improve adenoma detection, assess tumoral consistency, or aid distinction from other sellar/parasellar lesions (e.g., aneurysm, meningioma). However, there remains a small but important subgroup of patients in whom primary or secondary intervention (e.g., first or redo transsphenoidal surgery, stereotactic radiosurgery) is limited by the inability of MRI to accurately localize the site(s) of de novo, persistent, or recurrent PA. Emerging evidence indicates that hybrid imaging, which combines molecular (e.g. 11C-methionine PET) and cross-sectional (MRI) modalities, can enable the detection and precise localization of sites of active tumor to guide targeted intervention. This not only increases the likelihood of achieving complete remission with preservation of remaining normal pituitary function but may mitigate the need for long-term (even lifelong) high-cost medical therapies. Here, we review published evidence supporting the use of molecular imaging in the management of PAs, including our own 10-y experience with 11C-methionine PET.