Loading…

Clinical use of [18F]fluoro-ethyl-L-tyrosine PET co-registered with MRI for localizing prolactinoma remnants

Purpose To assess the utility of [ 18 F]fluoroethyl-L-tyrosine PET co-registered with magnetic resonance imaging ([ 18 F]FET-PET/MRI CR ) in patients with difficult-to-localize prolactinoma to inform clinical decision-making and (surgical) treatment planning. Methods Retrospective cohort study of 17...

Full description

Saved in:
Bibliographic Details
Published in:Pituitary 2024-10, Vol.27 (5), p.614-624
Main Authors: van Trigt, Victoria R., Bakker, Leontine E. H., Lu, Huangling, Pelsma, Iris C. M., Verstegen, Marco J. T., van Furth, Wouter R., Pereira Arias-Bouda, Lenka M., Biermasz, Nienke R.
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Purpose To assess the utility of [ 18 F]fluoroethyl-L-tyrosine PET co-registered with magnetic resonance imaging ([ 18 F]FET-PET/MRI CR ) in patients with difficult-to-localize prolactinoma to inform clinical decision-making and (surgical) treatment planning. Methods Retrospective cohort study of 17 consecutive patients with prolactinoma undergoing [ 18 F]FET-PET/MRI CR between October 2020 and September 2022 for either (1) additional information in case of difficult-to-visualize remnants after prior transsphenoidal surgery (TSS), or pharmacological treatment, or (2) radiological diagnosis in absence of a (clear) adenoma on diagnostic/post-treatment conventional MRI. Results [ 18 F]FET-PET/MRI CR identified a lesion in 14/17 patients, yet failed to identify active lesions in 2 patients with negative conventional MRI despite prolactin > 7.5 times upper limit of normal. [ 18 F]FET-PET/MRI CR results were inconclusive in 1 patient due to diffuse tracer uptake 10 weeks post-surgery. [ 18 F]FET-PET/MRI CR was completely concordant with a suspected lesion on conventional MRI in 10/17 patients, and partially concordant in 3/17 patients. New foci were identified in 4/17 patients. The [ 18 F]FET-PET/MRI CR conclusions influenced clinical shared decision-making in 15/17 patients, of whom 7 patients underwent TSS and 8 refrained from TSS. One patient underwent TSS despite negative [ 18 F]FET-PET/MRI CR , and one patient underwent additional imaging. Intraoperative findings corresponded with [ 18 F]FET-PET/MRI CR in 5/8 patients, and immunohistochemistry was positive in 5/8 patients. The treatment goal was achieved in 7/8 patients, and remission was achieved in 5/7 patients in whom total resection was considered feasible. Conclusion [ 18 F]FET-PET/MRI CR can be of added value in the preoperative decision-making process for selected patients with difficult-to-localize prolactinoma (remnants), or patients lacking a substrate on conventional MRI.
ISSN:1386-341X
1573-7403
DOI:10.1007/s11102-024-01430-y