Real-world experience with 11C-methionine positron emission tomography in the management of acromegaly
Authors' conclusion
In patients with persistent/recurrent acromegaly or occult tumors, Met-PET can facilitate further targeted intervention (surgery/radiosurgery). This led to complete remission in most cases (24/33) or significant improvement with comparatively low risk of complications. L-[methyl-11C]-methionine-positron emission tomography should therefore be considered in all patients who are potential candidates for further surgical intervention but present no clear target on MRI.
Study context
- Population
- Patients with acromegaly referred to a national methionine-positron emission tomography (Met-PET) service and managed exclusively by one multidisciplinary team; referrals for indeterminate magnetic resonance imaging (MRI), occult residual, (radio-)surgical planning or occult de novo tumourof 189 referred
- Participants
- 61 patients
- Outcome
- Complete biochemical remission after PET-guided (re-)surgery
Methodological detailssingle surgeon
- Single surgeon
Main finding
As reported in the abstract
Underwent PET-guided surgery
33 of 61
54.1%
Complete biochemical remission after (re-)surgery
24 of 33
72.7%
Observational data: associations, not effects.
Further findings
IGF-1 in patients without remission
- IGF-1 reduced to <2 × upper limit of normal (ULN)
- 6 of the remaining 9
- IGF-1 <1.1 × ULN
- 3
- Mean preoperative IGF-1 (n = 9)
- 2.4 × ULN (SD 0.8)
Safety
Complications after surgery
- Single new hormonal deficits (gonadotropic/thyrotropic insufficiency)
- 3 patients
- Neurovascular complications
- 0
Original publication
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