Diagnostic Value of 11C-Methionine PET-CT Imaging in Persistent or Recurrent Cushing Disease After Surgery
Authors' conclusion
11C-MET PET/CT imaging can provide valuable diagnostic information to detect a corticotroph microadenoma in more than half of patients with persistent/recurrent CD and equivocal or negative MRI findings, allowing targeted TSS or radiosurgery with a global success rate of 64% in the selected subgroup with positive imaging.
Study context
- Population
- Patients with persistent/recurrent Cushing disease (CD) after initial transsphenoidal surgery (TSS) and equivocal/negative pituitary magnetic resonance imaging (MRI); 18 female; mean age 36 years at diagnosisMay 2002–Nov 2023
- Participants
- 22 patients
- Outcome
- Diagnostic utility of 11C-MET PET/CT in localizing residual or relapsing corticotroph adenoma
Methodological details2 tertiary centres
- 2 tertiary centres
Performance
As reported in the abstract
Detection by 11C-MET PET/CT
SUVmaxT found in suspect area
14 patients
63.5%
Detected with negative pituitary MRI
5 of 9
Detected with equivocal MRI findings
9 of 13
Detection rate accuracy of positive 11C-MET PET/CT
86%
12/14
Further findings
Treatment outcomes after positive imaging
- Repeat TSS, successful
- 7 of 12
- Gamma Knife radiosurgery (GKRS), remission
- 2 of 2
- Total remission rate
- 64%
- Corticotroph adenoma in resected tissue among those not cured by TSS
- 3 of 5
Outcomes in PET-negative patients (n=8)
- Exploratory TSS, no remission
- 2 patients
- GKRS, long-term remission
- 1 of 2
Original publication
Diagnostic Value of 11C-Methionine PET-CT Imaging in Persistent or Recurrent Cushing Disease After Surgery. J Clin Endocrinol Metab. Published 28 January 2025. doi:10.
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