Utility of N-13-Ammonia PET/CT to Detect Pituitary Tissue in Patients with Pituitary Adenomas

作者：Wang, Zongming; Mao, Zhigang; Zhang, Xiangsong; He, Dongsheng; Wang, Xin; Du, Qiu; Xiao, Zheng; Zhu, Diming; Zhu, Yonghong^*; Wang, Haijun^*

来源：Academic Radiology, 2019, 26(9): 1222-1228.

DOI：10.1016/j.acra.2018.09.015

• N-13-ammonia
• F-18-FDG
• Positron-emission tomography/Computed tomography (PET/CT)
• Pituitary adenoma
• Pituitary tissue

Rationale and Objectives: It is clinically essential, but sometimes challenging, to distinguish pituitary tissue from pituitary adenomas (PAs). It is helpful to avoid damage of pituitary tissue during management. We evaluated the ability of N-13-ammonia positron emission tomography (PET)/computed tomography (CT) to locate and distinguish pituitary tissue from PAs.
Materials and Methods: Forty-eight patients (four with prolactinoma, 10 with Cushing's disease, 12 with acromegaly, and 22 with nonfunctional PAs) prospectively underwent magnetic resonance imaging (MRI), N-13-ammonia PET/CT, F-18-FDG PET/CT, prior to surgery.
Results: Pituitary position could be determined in 31 (64.5%) patients by N-13-ammonia PET/CT, and by MRI in 26 (54.2%) patients. It was detected by N-13-ammonia PET/CT and MRI in eight of eight patients (100%) with pituitary microadenoma, tumor maximum diameter (TMD) <1 cm, and in nine of 10 patients (90%) with PAs with TMD >= 1 cm, but <2 cm. In 16 patients with PAs with TMD >= 2 cm, but <3 cm, pituitary tissue position was detected by N-13-ammonia PET/CT in nine (56%), and by MRI in 8 (50.0%) patients by MRI. In 14 patients with PAs with TMD >= 3 cm, pituitary tissue position was detected by N-13-ammonia PET/CT in five (35.7%) patient, and by MRI in 1 (7.1%). In seven patients, the pituitary tissue could be detected by N-13-ammonia PET, but not by MRI, and in two patients by MRI, but not by N-13-ammonia PET.
Conclusion: N-13-ammonia PET/CT imaging is a sensitive means for locating and distinguishing pituitary tissue from PAs, particularly those with TMD <2 cm. It is potentially valuable in detection of pituitary tissue in patients with PAs.

• 出版日期2019-9
• 单位中山大学