Analysis of 18F-fluorodeoxyglucose positron emission tomography findings in patients with pituitary lesions

• Published in: The Korean journal of internal medicine Vol. 28; no. 1; pp. 81 - 88
• Main Authors: Seok, Hannah, Lee, Eun Young, Choe, Eun Yeong, Yang, Woo In, Kim, Joo Young, Shin, Dong Yeob, Cho, Ho Jin, Kim, Tae Sung, Yun, Mi Jin, Lee, Jong Doo, Lee, Eun Jig, Lim, Sung-Kil, Rhee, Yumie
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Association of Internal Medicine 01.01.2013; 대한내과학회
• Subjects: Adenoma - diagnostic imaging; Adenoma - pathology; Adolescent; Adult; Aged; Aged, 80 and over; Female; Fluorodeoxyglucose F18; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Original; Pituitary Gland - diagnostic imaging; Pituitary Gland - pathology; Pituitary Neoplasms - diagnostic imaging; Pituitary Neoplasms - pathology; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Tumor Burden; Young Adult; 내과학; Positron-emission tomography; Magnetic resonance imaging; Pituitary
• ISSN: 2005-6648; 1226-3303; 2005-6648
• DOI: 10.3904/kjim.2013.28.1.81

Although magnetic resonance imaging (MRI) is a good visual modality for the evaluation of pituitary lesions, it has limited value in the diagnosis of mixed nodules and some cystic lesions. We evaluated the usefulness of (18)F-fluorodeoxyglucose positron emission tomography (FDG PET) for patients with pituitary lesions. (18)F-FDG PET and MRI were performed simultaneously in 32 consecutive patients with pituitary lesions. The relationships between FDG uptake patterns in PET and MRI findings were analyzed. Of 24 patients with piuitary adenomas, 19 (79.2%) showed increased uptake of (18)F-FDG in the pituitary gland on PET scans. All patients with pituitary macroadenomas showed increased (18)F-FDG uptake on PET scans. Meanwhile, only five (50%) of the 10 patients with pituitary microadenomas showed positive PET scans. Interestingly, of two patients with no abnormal MRI findings, one showed increased (18)F-FDG uptake on PET. For positive (18)F-FDG uptake, maximum standardized uptake values (SUV(max)) > 2.4 had 94.7% sensitivity and 100% specificity. In addition, SUV(max) increased in proportion to the size of pituitary adenomas. Most cystic lesions did not show (18)F-FDG uptake on PET scans. About 80% of pituitary adenomas showed positivity on PET scans, and SUV(max) was related to the size of the adenomas. PET may be used as an ancillary tool for detection and differentiation of pituitary lesions.