Clinical use of [18F]fluoro-ethyl-L-tyrosine PET co-registered with MRI for localizing prolactinoma remnants
Authors' conclusion
[18F]FET-PET/MRICR 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.
Study context
- Population
- Patients with difficult-to-localize prolactinoma: difficult-to-visualize remnants after prior transsphenoidal surgery (TSS) or pharmacological treatment, or no (clear) adenoma on diagnostic/post-treatment conventional MRI; October 2020–September 2022
- Participants
- 17 consecutive patients
- Outcome
- Lesion identification by [18F]FET-PET/MRICR
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
- Lesion identified
- 14/17 patients
- Failed to identify active lesions despite negative conventional MRI and prolactin > 7.5 times upper limit of normal
- 2 patients
- Inconclusive (diffuse tracer uptake 10 weeks post-surgery)
- 1 patient
- Completely concordant with suspected lesion on conventional MRI
- 10/17 patients
- Partially concordant with conventional MRI
- 3/17 patients
- New foci identified
- 4/17 patients
Observational data: associations, not effects.
Further findings
Influence on clinical shared decision-making
- Conclusions influenced decision-making
- 15/17 patients
- Of these, underwent TSS
- 7 patients
- Of these, refrained from TSS
- 8 patients
- Underwent TSS despite negative [18F]FET-PET/MRICR
- 1 patient
- Underwent additional imaging
- 1 patient
Surgical outcomes
- Intraoperative findings corresponded with [18F]FET-PET/MRICR
- 5/8 patients
- Immunohistochemistry positive
- 5/8 patients
- Treatment goal achieved
- 7/8 patients
- Remission where total resection considered feasible
- 5/7 patients
Original publication
Clinical use of [18F]fluoro-ethyl-L-tyrosine PET co-registered with MRI for localizing prolactinoma remnants. Pituitary. Published 23 July 2024. doi:10.
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