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Published in: Pituitary 4/2023

07-06-2023 | Research

[68 Ga]-DOTATATE PET/MR-based evaluation of physiologic somatostatin receptor 2 expression in the adult pituitary gland as a function of age and sex in a prospective cohort

Authors: Sean H. Kim, Se Jung Chris Chang, Georgiana Dobri, Sara Strauss, Eaton Lin, Vaz Zavaletta, Susan C. Pannullo, Joseph R. Osborne, Theodore H. Schwartz, Jonathan P. S. Knisely, Jana Ivanidze

Published in: Pituitary | Issue 4/2023

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Abstract

Purpose

The pituitary gland has the fourth highest physiologic avidity of [68 Ga]-DOTATATE. In order to guide our understanding of [68 Ga]-DOTATATE PET in clinical contexts, accurate characterization of the normal pituitary gland is first required. This study aimed to characterize the normal pituitary gland using dedicated brain [68 Ga]-DOTATATE PET/MRI as a function of age and sex.

Methods

A total of 95 patients with a normal pituitary gland underwent brain [68 Ga]-DOTATATE PET examinations for the purpose of diagnosing CNS SSTR2 positive tumors (mean age: 58.9, 73% female). Maximum SUV of the pituitary gland was obtained in each patient. SUV of superior sagittal sinus was obtained to calculate normalized SUV score (SUVR) of the gland. The anatomic size of the gland was collected as maximum sagittal height (MSH). Correlations with age and sex were analyzed.

Results

The mean SUV and SUVR of the pituitary gland were 17.6 (range: 7–59.5, SD = 7.1) and 13.8 (range: 3.3–52.6, SD = 7.2), respectively. Older females had significantly higher SUV of the pituitary gland compared to younger females. When stratified by age and sex, both older and younger females had significantly higher pituitary SUV than older males. SUVR did not differ significantly by age or sex. MSH of the pituitary gland in younger females was significantly greater than in younger males at all age cutoffs.

Conclusion

This study provides an empiric profiling of the physiological [68 Ga]-DOTATATE avidity of the pituitary gland. The findings suggest that SUV may vary by age and sex and can help guide the use of [68 Ga]-DOTATATE PET/MRI in clinical and research settings. Future studies can build on these findings to investigate further the relationship between pituitary biology and demographic factors.
Literature
1.
go back to reference Eigler T, Ben-Shlomo A (2014) Somatostatin system: molecular mechanisms regulating anterior pituitary hormones. J Mol Endocrinol 53:R1-19PubMedCrossRef Eigler T, Ben-Shlomo A (2014) Somatostatin system: molecular mechanisms regulating anterior pituitary hormones. J Mol Endocrinol 53:R1-19PubMedCrossRef
2.
go back to reference Panetta R, Patel YC (1995) Expression of mRNA for all five human somatostatin receptors (hSSTR1-5) in pituitary tumors. Life Sci 56:333–342PubMedCrossRef Panetta R, Patel YC (1995) Expression of mRNA for all five human somatostatin receptors (hSSTR1-5) in pituitary tumors. Life Sci 56:333–342PubMedCrossRef
3.
go back to reference Tebani A, Jotanovic J, Hekmati N et al (2021) Annotation of pituitary neuroendocrine tumors with genome-wide expression analysis. Acta Neuropathol Commun 9:181PubMedPubMedCentralCrossRef Tebani A, Jotanovic J, Hekmati N et al (2021) Annotation of pituitary neuroendocrine tumors with genome-wide expression analysis. Acta Neuropathol Commun 9:181PubMedPubMedCentralCrossRef
5.
go back to reference Thodou E, Kontogeorgos G (2020) Somatostatin receptor profile in pituitary thyrotroph adenomas. Clin Neurol Neurosurg 195:105865PubMedCrossRef Thodou E, Kontogeorgos G (2020) Somatostatin receptor profile in pituitary thyrotroph adenomas. Clin Neurol Neurosurg 195:105865PubMedCrossRef
6.
go back to reference Vieria Neto L, Wildemberg LE, Colli LM et al (2013) ZAC1 and SSTR2 are downregulated in non-functioning pituitary adenomas but not in somatotropinomas. PLoS ONE 8:e77406PubMedPubMedCentralCrossRef Vieria Neto L, Wildemberg LE, Colli LM et al (2013) ZAC1 and SSTR2 are downregulated in non-functioning pituitary adenomas but not in somatotropinomas. PLoS ONE 8:e77406PubMedPubMedCentralCrossRef
7.
go back to reference Nishioka H, Tamura K, Iida H et al (2011) Co-expression of somatostatin receptor subtypes and estrogen receptor-α mRNAs by non-functioning pituitary adenomas in young patients. Mol Cell Endocrinol 331:73–78PubMedCrossRef Nishioka H, Tamura K, Iida H et al (2011) Co-expression of somatostatin receptor subtypes and estrogen receptor-α mRNAs by non-functioning pituitary adenomas in young patients. Mol Cell Endocrinol 331:73–78PubMedCrossRef
8.
go back to reference Taboada GF, Luque RM, Bastos W et al (2007) Quantitative analysis of somatostatin receptor subtype (SSTR1-5) gene expression levels in somatotropinomas and non-functioning pituitary adenomas. Eur J Endocrinol 156:65–74PubMedCrossRef Taboada GF, Luque RM, Bastos W et al (2007) Quantitative analysis of somatostatin receptor subtype (SSTR1-5) gene expression levels in somatotropinomas and non-functioning pituitary adenomas. Eur J Endocrinol 156:65–74PubMedCrossRef
9.
go back to reference Øystese KA, Casar-Borota O, Normann KR, Zucknick M, Berg JP, Bollerslev J (2017) Estrogen receptor α, a sex-dependent predictor of aggressiveness in nonfunctioning pituitary adenomas: SSTR and sex hormone receptor distribution in NFPA. J Clin Endocrinol Metab 102:3581–3590PubMedCrossRef Øystese KA, Casar-Borota O, Normann KR, Zucknick M, Berg JP, Bollerslev J (2017) Estrogen receptor α, a sex-dependent predictor of aggressiveness in nonfunctioning pituitary adenomas: SSTR and sex hormone receptor distribution in NFPA. J Clin Endocrinol Metab 102:3581–3590PubMedCrossRef
10.
go back to reference Tjörnstrand A, Casar-Borota O, Heurling K et al (2020) Lower (68) Ga-DOTATOC uptake in nonfunctioning pituitary neuroendocrine tumours compared to normal pituitary gland-A proof-of-concept study. Clin Endocrinol (Oxf) 92:222–231PubMedCrossRef Tjörnstrand A, Casar-Borota O, Heurling K et al (2020) Lower (68) Ga-DOTATOC uptake in nonfunctioning pituitary neuroendocrine tumours compared to normal pituitary gland-A proof-of-concept study. Clin Endocrinol (Oxf) 92:222–231PubMedCrossRef
11.
go back to reference Fusco A, Giampietro A, Bianchi A et al (2012) Treatment with octreotide LAR in clinically non-functioning pituitary adenoma: results from a case-control study. Pituitary 15:571–578PubMedCrossRef Fusco A, Giampietro A, Bianchi A et al (2012) Treatment with octreotide LAR in clinically non-functioning pituitary adenoma: results from a case-control study. Pituitary 15:571–578PubMedCrossRef
12.
go back to reference Ramírez C, Cheng S, Vargas G et al (2012) Expression of Ki-67, PTTG1, FGFR4, and SSTR 2, 3, and 5 in nonfunctioning pituitary adenomas: a high throughput TMA, immunohistochemical study. J Clin Endocrinol Metab 97:1745–1751PubMedCrossRef Ramírez C, Cheng S, Vargas G et al (2012) Expression of Ki-67, PTTG1, FGFR4, and SSTR 2, 3, and 5 in nonfunctioning pituitary adenomas: a high throughput TMA, immunohistochemical study. J Clin Endocrinol Metab 97:1745–1751PubMedCrossRef
13.
go back to reference Gabalec F, Drastikova M, Cesak T et al (2015) Dopamine 2 and somatostatin 1–5 receptors coexpression in clinically non-functioning pituitary adenomas. Physiol Res 64:369–377PubMedCrossRef Gabalec F, Drastikova M, Cesak T et al (2015) Dopamine 2 and somatostatin 1–5 receptors coexpression in clinically non-functioning pituitary adenomas. Physiol Res 64:369–377PubMedCrossRef
14.
go back to reference Reubi JC, Schar JC, Waser B et al (2000) Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 27:273–282PubMedCrossRef Reubi JC, Schar JC, Waser B et al (2000) Affinity profiles for human somatostatin receptor subtypes SST1-SST5 of somatostatin radiotracers selected for scintigraphic and radiotherapeutic use. Eur J Nucl Med 27:273–282PubMedCrossRef
15.
go back to reference Ozguven S, Filizoglu N, Kesim S et al (2021) Physiological Biodistribution of (68)Ga-DOTA-TATE in Normal Subjects. Mol Imaging Radionucl Ther 30:39–46PubMedPubMedCentralCrossRef Ozguven S, Filizoglu N, Kesim S et al (2021) Physiological Biodistribution of (68)Ga-DOTA-TATE in Normal Subjects. Mol Imaging Radionucl Ther 30:39–46PubMedPubMedCentralCrossRef
17.
go back to reference Kunz WG, Jungblut LM, Kazmierczak PM et al (2017) Improved detection of transosseous meningiomas using (68)Ga-DOTATATE PET/CT compared with contrast-enhanced MRI. J Nucl Med 58:1580–1587PubMedCrossRef Kunz WG, Jungblut LM, Kazmierczak PM et al (2017) Improved detection of transosseous meningiomas using (68)Ga-DOTATATE PET/CT compared with contrast-enhanced MRI. J Nucl Med 58:1580–1587PubMedCrossRef
18.
go back to reference Ivanidze J, Roytman M, Lin E et al (2019) Gallium-68 DOTATATE PET in the evaluation of Intracranial Meningiomas. J Neuroimaging 29:650–656PubMedCrossRef Ivanidze J, Roytman M, Lin E et al (2019) Gallium-68 DOTATATE PET in the evaluation of Intracranial Meningiomas. J Neuroimaging 29:650–656PubMedCrossRef
20.
go back to reference Kim SH, Roytman M, Kamen E et al (2021) [68Ga]-DOTATATE PET/MRI in the diagnosis and management of recurrent head and neck paraganglioma with spinal metastasis. Clin Imaging 79:314–318PubMedCrossRef Kim SH, Roytman M, Kamen E et al (2021) [68Ga]-DOTATATE PET/MRI in the diagnosis and management of recurrent head and neck paraganglioma with spinal metastasis. Clin Imaging 79:314–318PubMedCrossRef
21.
go back to reference Kim SH, Roytman M, Madera G et al (2022) Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [(68)Ga]-DOTATATE PET/MRI analysis in patients with meningioma. Sci Rep 12:9256PubMedPubMedCentralCrossRef Kim SH, Roytman M, Madera G et al (2022) Evaluating diagnostic accuracy and determining optimal diagnostic thresholds of different approaches to [(68)Ga]-DOTATATE PET/MRI analysis in patients with meningioma. Sci Rep 12:9256PubMedPubMedCentralCrossRef
22.
go back to reference Sen R, Sen C, Pack J et al (2017) Role of high-resolution dynamic contrast-enhanced mri with golden-angle radial sparse parallel reconstruction to identify the normal pituitary gland in patients with macroadenomas. AJNR Am J Neuroradiol 38:1117–1121PubMedPubMedCentralCrossRef Sen R, Sen C, Pack J et al (2017) Role of high-resolution dynamic contrast-enhanced mri with golden-angle radial sparse parallel reconstruction to identify the normal pituitary gland in patients with macroadenomas. AJNR Am J Neuroradiol 38:1117–1121PubMedPubMedCentralCrossRef
23.
go back to reference Berntsen EM, Haukedal MD, Håberg AK (2021) Normative data for pituitary size and volume in the general population between 50 and 66 years. Pituitary 24:737–745PubMedPubMedCentralCrossRef Berntsen EM, Haukedal MD, Håberg AK (2021) Normative data for pituitary size and volume in the general population between 50 and 66 years. Pituitary 24:737–745PubMedPubMedCentralCrossRef
24.
go back to reference Sari S, Sari E, Akgun V et al (2014) Measures of pituitary gland and stalk: from neonate to adolescence. J Pediatr Endocrinol Metab 27:1071–1076PubMed Sari S, Sari E, Akgun V et al (2014) Measures of pituitary gland and stalk: from neonate to adolescence. J Pediatr Endocrinol Metab 27:1071–1076PubMed
25.
go back to reference Singh AKC, Kandasamy D, Garg A, Jyotsna VP, Khadgawat R (2018) Study of pituitary morphometry using MRI in Indian subjects. Indian J Endocrinol Metab 22:605–609PubMedPubMedCentralCrossRef Singh AKC, Kandasamy D, Garg A, Jyotsna VP, Khadgawat R (2018) Study of pituitary morphometry using MRI in Indian subjects. Indian J Endocrinol Metab 22:605–609PubMedPubMedCentralCrossRef
26.
go back to reference Wang H, Hou B, Lu L et al (2018) PET/MRI in the diagnosis of hormone-producing pituitary microadenoma: a prospective pilot study. J Nucl Med 59:523–528PubMedCrossRef Wang H, Hou B, Lu L et al (2018) PET/MRI in the diagnosis of hormone-producing pituitary microadenoma: a prospective pilot study. J Nucl Med 59:523–528PubMedCrossRef
27.
go back to reference Zhao X, Xiao J, Xing B, Wang R, Zhu Z, Li F (2014) Comparison of (68)Ga DOTATATE to 18F-FDG uptake is useful in the differentiation of residual or recurrent pituitary adenoma from the remaining pituitary tissue after transsphenoidal adenomectomy. Clin Nucl Med 39:605–608PubMedCrossRef Zhao X, Xiao J, Xing B, Wang R, Zhu Z, Li F (2014) Comparison of (68)Ga DOTATATE to 18F-FDG uptake is useful in the differentiation of residual or recurrent pituitary adenoma from the remaining pituitary tissue after transsphenoidal adenomectomy. Clin Nucl Med 39:605–608PubMedCrossRef
28.
go back to reference MacMaster FP, Keshavan M, Mirza Y et al (2007) Development and sexual dimorphism of the pituitary gland. Life Sci 80:940–944PubMedCrossRef MacMaster FP, Keshavan M, Mirza Y et al (2007) Development and sexual dimorphism of the pituitary gland. Life Sci 80:940–944PubMedCrossRef
29.
go back to reference Elster AD, Chen MY, Williams DW 3rd, Key LL (1990) Pituitary gland: MR imaging of physiologic hypertrophy in adolescence. Radiology 174:681–685PubMedCrossRef Elster AD, Chen MY, Williams DW 3rd, Key LL (1990) Pituitary gland: MR imaging of physiologic hypertrophy in adolescence. Radiology 174:681–685PubMedCrossRef
30.
go back to reference Doraiswamy PM, Potts JM, Axelson DA et al (1992) MR assessment of pituitary gland morphology in healthy volunteers: age- and gender-related differences. AJNR Am J Neuroradiol 13:1295–1299PubMedPubMedCentral Doraiswamy PM, Potts JM, Axelson DA et al (1992) MR assessment of pituitary gland morphology in healthy volunteers: age- and gender-related differences. AJNR Am J Neuroradiol 13:1295–1299PubMedPubMedCentral
31.
go back to reference Tsunoda A, Okuda O, Sato K (1997) MR height of the pituitary gland as a function of age and sex: especially physiological hypertrophy in adolescence and in climacterium. AJNR Am J Neuroradiol 18:551–554PubMedPubMedCentral Tsunoda A, Okuda O, Sato K (1997) MR height of the pituitary gland as a function of age and sex: especially physiological hypertrophy in adolescence and in climacterium. AJNR Am J Neuroradiol 18:551–554PubMedPubMedCentral
32.
go back to reference National Academies of Sciences E, Medicine, Division of B, et al. The National Academies Collection: Reports funded by National Institutes of Health. In: Becker T, Chin M, Bates N, eds. Measuring Sex, Gender Identity, and Sexual Orientation. Washington (DC): National Academies Press (US) Copyright 2022 by the National Academy of Sciences. All rights reserved., 2022 National Academies of Sciences E, Medicine, Division of B, et al. The National Academies Collection: Reports funded by National Institutes of Health. In: Becker T, Chin M, Bates N, eds. Measuring Sex, Gender Identity, and Sexual Orientation. Washington (DC): National Academies Press (US) Copyright 2022 by the National Academy of Sciences. All rights reserved., 2022
33.
go back to reference Riaz H, Dong P, Shahzad M, Yang L (2014) Constitutive and follicle-stimulating hormone-induced action of somatostatin receptor-2 on regulation of apoptosis and steroidogenesis in bovine granulosa cells. J Steroid Biochem Mol Biol 141:150–159PubMedCrossRef Riaz H, Dong P, Shahzad M, Yang L (2014) Constitutive and follicle-stimulating hormone-induced action of somatostatin receptor-2 on regulation of apoptosis and steroidogenesis in bovine granulosa cells. J Steroid Biochem Mol Biol 141:150–159PubMedCrossRef
34.
go back to reference Kimura N, Hayafuji C, Konagaya H, Takahashi K (1986) 17 beta-estradiol induces somatostatin (SRIF) inhibition of prolactin release and regulates SRIF receptors in rat anterior pituitary cells. Endocrinology 119:1028–1036PubMedCrossRef Kimura N, Hayafuji C, Konagaya H, Takahashi K (1986) 17 beta-estradiol induces somatostatin (SRIF) inhibition of prolactin release and regulates SRIF receptors in rat anterior pituitary cells. Endocrinology 119:1028–1036PubMedCrossRef
35.
go back to reference Djordjijevic D, Zhang J, Priam M et al (1998) Effect of 17beta-estradiol on somatostatin receptor expression and inhibitory effects on growth hormone and prolactin release in rat pituitary cell cultures. Endocrinology 139:2272–2277PubMedCrossRef Djordjijevic D, Zhang J, Priam M et al (1998) Effect of 17beta-estradiol on somatostatin receptor expression and inhibitory effects on growth hormone and prolactin release in rat pituitary cell cultures. Endocrinology 139:2272–2277PubMedCrossRef
36.
go back to reference Visser-Wisselaar HA, Van Uffelen CJ, Van Koetsveld PM et al (1997) 17-beta-estradiol-dependent regulation of somatostatin receptor subtype expression in the 7315b prolactin secreting rat pituitary tumor in vitro and in vivo. Endocrinology 138:1180–1189PubMedCrossRef Visser-Wisselaar HA, Van Uffelen CJ, Van Koetsveld PM et al (1997) 17-beta-estradiol-dependent regulation of somatostatin receptor subtype expression in the 7315b prolactin secreting rat pituitary tumor in vitro and in vivo. Endocrinology 138:1180–1189PubMedCrossRef
37.
go back to reference Lin X, Janovick JA, Cardenas R, Conn PM, Peter RE (2000) Molecular cloning and expression of a type-two somatostatin receptor in goldfish brain and pituitary. Mol Cell Endocrinol 166:75–87PubMedCrossRef Lin X, Janovick JA, Cardenas R, Conn PM, Peter RE (2000) Molecular cloning and expression of a type-two somatostatin receptor in goldfish brain and pituitary. Mol Cell Endocrinol 166:75–87PubMedCrossRef
38.
go back to reference Yan M, Jones ME, Hernandez M, Liu D, Simpson ER, Chen C (2005) Oestrogen replacement in vivo rescues the dysfunction of pituitary somatotropes in ovariectomised aromatase knockout mice. Neuroendocrinology 81:158–166PubMedCrossRef Yan M, Jones ME, Hernandez M, Liu D, Simpson ER, Chen C (2005) Oestrogen replacement in vivo rescues the dysfunction of pituitary somatotropes in ovariectomised aromatase knockout mice. Neuroendocrinology 81:158–166PubMedCrossRef
39.
go back to reference Señarís RM, Lago F, Diéguez C (1996) Gonadal regulation of somatostatin receptor 1, 2 and 3 mRNA levels in the rat anterior pituitary. Brain Res Mol Brain Res 38:171–175PubMedCrossRef Señarís RM, Lago F, Diéguez C (1996) Gonadal regulation of somatostatin receptor 1, 2 and 3 mRNA levels in the rat anterior pituitary. Brain Res Mol Brain Res 38:171–175PubMedCrossRef
40.
go back to reference Canosa LF, Lin X, Peter RE (2003) Effects of sex steroid hormones on the expression of somatostatin receptors sst1 and sst5 in goldfish pituitary and forebrain. Neuroendocrinology 78:81–89PubMedCrossRef Canosa LF, Lin X, Peter RE (2003) Effects of sex steroid hormones on the expression of somatostatin receptors sst1 and sst5 in goldfish pituitary and forebrain. Neuroendocrinology 78:81–89PubMedCrossRef
41.
go back to reference Dinç H, Esen F, Demirci A, Sari A, Resit GH (1998) Pituitary dimensions and volume measurements in pregnancy and post partum. MR assessment Acta Radiol 39:64–69PubMed Dinç H, Esen F, Demirci A, Sari A, Resit GH (1998) Pituitary dimensions and volume measurements in pregnancy and post partum. MR assessment Acta Radiol 39:64–69PubMed
43.
go back to reference Grams AE, Gempt J, Stahl A, Förschler A (2010) Female pituitary size in relation to age and hormonal factors. Neuroendocrinology 92:128–132PubMedCrossRef Grams AE, Gempt J, Stahl A, Förschler A (2010) Female pituitary size in relation to age and hormonal factors. Neuroendocrinology 92:128–132PubMedCrossRef
44.
go back to reference Abech DD, Moratelli HB, Leite SC, Oliveira MC (2005) Effects of estrogen replacement therapy on pituitary size, prolactin and thyroid-stimulating hormone concentrations in menopausal women. Gynecol Endocrinol 21:223–226PubMedCrossRef Abech DD, Moratelli HB, Leite SC, Oliveira MC (2005) Effects of estrogen replacement therapy on pituitary size, prolactin and thyroid-stimulating hormone concentrations in menopausal women. Gynecol Endocrinol 21:223–226PubMedCrossRef
45.
go back to reference Chen KX, Worley S, Foster H et al (2021) Oral contraceptive use is associated with smaller hypothalamic and pituitary gland volumes in healthy women: a structural MRI study. PLoS ONE 16:e0249482PubMedPubMedCentralCrossRef Chen KX, Worley S, Foster H et al (2021) Oral contraceptive use is associated with smaller hypothalamic and pituitary gland volumes in healthy women: a structural MRI study. PLoS ONE 16:e0249482PubMedPubMedCentralCrossRef
46.
go back to reference Fehrenbach U, Jadan A, Auer TA et al (2020) Obesity and pituitary gland volume - a correlation study using three-dimensional magnetic resonance imaging. Neuroradiol J 33:400–409PubMedPubMedCentralCrossRef Fehrenbach U, Jadan A, Auer TA et al (2020) Obesity and pituitary gland volume - a correlation study using three-dimensional magnetic resonance imaging. Neuroradiol J 33:400–409PubMedPubMedCentralCrossRef
Metadata
Title
[68 Ga]-DOTATATE PET/MR-based evaluation of physiologic somatostatin receptor 2 expression in the adult pituitary gland as a function of age and sex in a prospective cohort
Authors
Sean H. Kim
Se Jung Chris Chang
Georgiana Dobri
Sara Strauss
Eaton Lin
Vaz Zavaletta
Susan C. Pannullo
Joseph R. Osborne
Theodore H. Schwartz
Jonathan P. S. Knisely
Jana Ivanidze
Publication date
07-06-2023
Publisher
Springer US
Published in
Pituitary / Issue 4/2023
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-023-01329-0

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