scholarly journals The combination of 13N-ammonia and 11C-methionine in differentiation of residual/recurrent pituitary adenoma from the pituitary gland remnant after trans-sphenoidal Adenomectomy

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fangling Zhang ◽  
Qiao He ◽  
Ganhua Luo ◽  
Yali Long ◽  
Ruocheng Li ◽  
...  
Keyword(s):  
Quantitative Analysis ◽  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Gray Matter ◽  
Standard Uptake Value ◽  
Visual Evaluation ◽  
Additional Surgery ◽  
Pet Ct ◽  
Histological Confirmation ◽  
G Ratio

Abstract Background This study aimed to assess the clinical usefulness of 13N-ammonia and 11C- Methionine (MET) positron emission tomography (PET)/ computed tomography (CT) in the differentiation of residual/recurrent pituitary adenoma (RPA) from the pituitary gland remnant (PGR) after trans-sphenoidal adenomectomy. Methods Between June 2012 and December 2019, a total of 19 patients with a history of trans-sphenoidal adenomectomy before PET/CT scans and histological confirmation of RPA after additional surgery in our hospital were enrolled in this study. Images were interpreted by visual evaluation and semi-quantitative analysis. In semi-quantitative analysis, the maximum standard uptake value (SUVmax) of the target and gray matter was measured and the target uptake/gray matter uptake (T/G) ratio was calculated. Results The T/G ratios of 13N-ammonia were significantly higher in PGR than RPA (1.58 ± 0.69 vs 0.63 ± 1.37, P < 0.001), whereas the T/G ratios of 11C-MET were obviously lower in PGR than RPA (0.78 ± 0.35 vs 2.17 ± 0.54, P < 0.001). Using the canonical discriminant analysis, we calculated the predicted accuracy of RPA (100%), PGR (92.9%), and the overall predicted accuracy (96.43%). Conclusions The combination of 13N-ammonia and 11C-MET PET/CT is valuable in the differentiation of RPA from PGR after trans-sphenoidal adenomectomy.

scholarly journals The Combination of 13N-ammonia and 11C-methionine in Differentiation of Residual/Recurrent Pituitary Adenoma From the Pituitary Gland Remnant After Trans-sphenoidal Adenomectomy

2021 ◽  
Author(s):  
lei ding ◽  
Qiao He ◽  
Ganhua Luo ◽  
Yali Long ◽  
Ruocheng Li ◽  
...  
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Standard Uptake Value ◽  
Pet Ct ◽  
History Of ◽  
Group A ◽  
Multiple Variables ◽  
G Ratio ◽  
Clinical Mri ◽  
Met Pet

Abstract ObjectiveTo assess the usefulness of 13N-ammonia and 11C- Methionine (MET) PET/CT in the differentiation of residual/recurrent pituitary adenoma (RPA) from the pituitary gland remnant (PGR) after trans-sphenoidal adenomectomy.Patients and MethodsBetween June 2012 to December 2019, 19 patients [clinical/MRI suggestion of RPA (14 female and 5 male, mean age: 44.86 ± 15.58 years, range: 18–79 years)] with a history of trans-sphenoidal adenomectomy before PET/CT scans in our department were enrolled in this study. The maximum standard uptake value (SUVmax) of the target and gray matter was measured, and then the T/G ratio was calculated. First, the T/G ratios of RPA and PGR for each tracer were compared by Student t-test. Second, the T/G ratios of the two tracers were adopted as multiple variables for canonical discrimination analysis. According to the canonical discriminant function, every patient was classified into one group. A P value less than 0.05 was considered statistically significant. ResultsThe T/G ratios of 13N-ammonia were significantly higher in PGR than RPA (1.58±0.69 vs 0.63±1.37, P< 0.001), whereas the T/G ratios of 11C-MET were significantly lower in PGR than RPA (0.78±0.35 vs 2.17±0.54, P < 0.001). By the canonical discriminant analysis, we calculated the predicted accuracy of RPA (100%), PGR (92.9%), and the overall predicted accuracy (96.43%). ConclusionsThe combination of 13N-ammonia and 11C-MET PET/CT is valuable in the differentiation of RPA from PGR after trans-sphenoidal adenomectomy.

Metastases to the Pituitary Gland: Histological Patterns of Spread and Review of the Literature

2021 ◽  
Author(s):  
B K Kleinschmidt-DeMasters
Keyword(s):  
Pituitary Adenoma ◽  
Pituitary Gland ◽  
Surgical Excision ◽  
Disease Course ◽  
Review Of The Literature ◽  
Metastatic Cells ◽  
Filling Pattern ◽  
Pituitary Metastases ◽  
Atypical Pituitary Adenoma ◽  
Disease Stages

Abstract Few studies have focused on histological patterns of metastatic spread to the pituitary gland. We review our experience and that in the literature, 1970–present. Departmental cases, 1998–2021, were assessed for anterior versus posterior gland and/or capsular involvement and cohesive tumor obliterating underlying pituitary architecture versus metastatic cells filling pituitary acini with relative acinar preservation. Eleven autopsy/15 surgical cases, including 2 metastases to pituitary adenomas, were identified. Cohesive/obliterative patterns predominated histologically in both surgical and autopsy cases, but acinar filling by metastatic cells was extensive in 3/26 cases, focal in 5/26, and had resulted in initial erroneous impressions of atypical pituitary adenoma/pituitary carcinoma in 1 case and pituitary adenoma with apoplexy in another, likely due to focusing on necrotic areas in the specimen where the acinar pattern had been broken down and not appreciating nearby areas with acinar filling by metastatic cells. Although most pituitary metastases produce readily identifiable cohesive/obliterative patterns, diagnostic challenges remain with the less frequently seen “acinar filling” pattern. A dichotomy exists between patients with symptomatic pituitary metastases occurring early in the disease course and requiring surgical excision versus patients in whom asymptomatic small pituitary metastases are found incidentally at autopsy, the latter almost invariably in late disease stages, with widely disseminated metastatic disease.

scholarly journals An unrecognized endocrinology emergency masquerading as a hypertensive emergency: A can’t miss diagnosis

2016 ◽  
Vol 4 (1) ◽  
pp. 21
Author(s):  
Yanerys Agosto Vargas ◽  
Sharon Velez Maymi ◽  
Paola Mansilla Letelier ◽  
Luis Raul Hernandez-Vazquez ◽  
Samayra Miranda Rodriguez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pituitary Adenoma ◽  
Mortality Rate ◽  
Pituitary Gland ◽  
Pituitary Apoplexy ◽  
Systemic Hypertension ◽  
Pituitary Macroadenoma ◽  
Rare Entity ◽  
Factors Associated ◽  
Multiple Risk Factors

Pituitary apoplexy secondary to sellar tumors is a rare entity that carries a high mortality rate. It could be secondary to infarction or hemorrhage of the pituitary gland. The incidence remains unclear, most are reported in men between the ages of 50 to 60. In the majority of times, apoplexy is idiopathic in nature, without a clear discernible cause. However, there are multiple risk factors associated with this entity, such as systemic hypertension, among others. There are few cases of pituitary apoplexy caused by infarction of a pituitary macroadenoma. We present this case of pituitary apoplexy secondary to infarction of a nonfunctional pituitary adenoma in a young woman, with a fortunate resolution.

Assessment of bone marrow status in diffuse B-cell large cell lymphoma: PET/CT capabilities

2021 ◽  
pp. 14-20
Author(s):  
N. A. Ognerubov ◽  
T. S. Antipova ◽  
A. V. Blokhin
Keyword(s):  
Bone Marrow ◽  
B Cell ◽  
Cell Lymphoma ◽  
Large Cell ◽  
Metabolic Imaging ◽  
Focal Lesions ◽  
Pet Ct ◽  
Bone Marrow Damage ◽  
Large Cell Lymphoma ◽  
Histological Confirmation

The aim of this work was to present the results of a retrospective study of 35 patients with morphologically diagnosed diffuse B-cell large cell lymphoma with bone marrow damage from 22 to 82 years old, median 63 years. There were 27 men and 8 women. After histological confirmation, all patients performed positron emission tomography combined with computed tomography with 18F-fluorodeoxyglucose (FDG PET/CT) followed by bone marrow trepanobiopsy. Specific bone marrow lesions were detected in 100% of cases with PET/CT and in 68.6% of cases with trepanobiopsy. Diffuse bone marrow damage was detected in 24 (68.6%) cases, focal – in 10 (28.6%) patients and in 1 (2.8%) patient – a mixed variant. The data obtained indicate the predominance of diffuse damage to the bone marrow. The statistical analysis established the value of the standardized maximum absorption coefficient of FDG SUVmax for bone marrow damage equal more than 3.58. Sensitivity was at 90% and a specificity was at 92%. The sensitivity of the PET/CT method is higher with focal lesions of the bone marrow than with diffuse. SUVmax was 10.26 ± 1.67 and 2.86 ± 0.09, respectively. The differences between them are significant (p < 0.0001). PET/CT is a non-invasive method of metabolic imaging allows you to assess the condition of the bone marrow and other extranodal symptoms of the disease at the stage of diagnosis, treatment and follow-up. It can replace the traditional method of bone marrow biopsy with diffuse B-cell large cell lymphoma.

Abstract 35: DVT Inflammation Assessed by 18F-FDG-PET/CT Predicts Subsequent Vein Wall Scarring

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Chase W Kessinger ◽  
Ahmed Tawakol ◽  
Gregory R Wojtkiewicz ◽  
Peter K Henke ◽  
Ralph Weissleder ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Vena Cava ◽  
Standard Uptake Value ◽  
Vein Wall ◽  
Positron Emission ◽  
Pet Ct ◽  
18F Fdg ◽  
The Right ◽  
Fdg Pet Ct

Objective: While venous thrombosis (VT)-induced inflammation facilitates thrombus resolution, inflammation causes vein wall scarring (VWS). Recently, statins have shown to improve VT resolution and reduce VT inflammatory components. In this study, we hypothesized that early VT inflammation detected by 18F-FDG positron emission tomography/computed tomography (PET/CT) could predict subsequent late stage VWS, and would be attenuated by statin therapy. Methods: Stasis VT was induced in 8-12 week old male C57BL/6 mice (n=31) in either the right jugular vein (n=13) or inferior vena cava (IVC,n=18). Animals in the IVC VT cohort were randomized to statin (n=8) or control (n=10) treatment. Statin, rosuvastatin (5mg/kg), was administered by oral gavage, daily starting 24 hours prior to VT induction; control mice received saline. All mice underwent survival FDG-PET/CT venography imaging on day 2. FDG inflammation signals (standard uptake value=SUV) were measured in the thrombosed vein and compared to the sham-operated venous segments or treatment control. On day 14, mice were sacrificed and VT tissue was resected. Picrosirius red staining allowed measurement of collagen and vein wall thickness in VT sections. Results: FDG-PET/CT at day 2 revealed increased inflammation signal activity in jugular VT (SUV 1.43 ± 0.3 VT vs. 0.81 ± 0.3 contralateral vein, p<0.0001). Statin-treated mice showed a trend of decreased inflammation signal at day 2 in the IVC VT models (SUV 1.02 ± 0.1 statin VT vs. 1.42 ± 0.2 control VT, p=0.07). Day 14 histological analysis revealed significantly reduced vein wall injury in statin-treated animals (thickness, 32±9.4 μm statin; vs. 56.2±14.7 μm control, p=0.02). Day 2 FDG-PET inflammation in VT correlated positively with the magnitude of day 14 VWS (jugular VT, Spearman r=0.62, p=0.02; IVC VT r=0.74, p<0.001, respectively). Conclusions: Quantitative FDG-PET/CT imaging demonstrates that early in vivo VT inflammation predicts subsequent VWS, a driver of post-thrombotic syndrome (PTS). The overall findings strengthen: (i) the link between inflammation and PTS; (ii) the translational potential of FDG-PET inflammation to predict VWS and PTS; and (iii) the concept that statins and other anti-inflammatory therapies could reduce VWS and PTS.

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