Top

Published in:

Open Access 26-05-2022 | Prolactinoma

Implementation of functional imaging using ¹¹C-methionine PET-CT co-registered with MRI for advanced surgical planning and decision making in prolactinoma surgery

Authors: Leontine E. H. Bakker, Marco J. T. Verstegen, Eidrees Ghariq, Berit M. Verbist, Pieter J. Schutte, Waiel A. Bashari, Mark C. Kruit, Alberto M. Pereira, Mark Gurnell, Nienke R. Biermasz, Wouter R. van Furth, Lenka M. Pereira Arias Bouda

Published in: Pituitary | Issue 4/2022

Abstract

Purpose

To report the first experience of our multidisciplinary team with functional imaging using ¹¹C-methionine positron emission tomography-computed tomography (¹¹C-methionine PET-CT) co-registered with MRI (Met-PET/MRI^CR) in clinical decision making and surgical planning of patients with difficult to treat prolactinoma.

Methods

In eighteen patients with prolactinoma, referred to our tertiary referral centre because of intolerance or resistance for dopamine agonists (DA), Met-PET/MRI^CR was used to aid decision-making regarding therapy.

Results

Met-PET/MRI^CR was positive in 94% of the patients. MRI and Met-PET/MRI^CR findings were completely concordant in five patients, partially concordant in nine patients, and non-concordant in four patients. In five patients Met-PET/MRI^CR identified lesion(s) that were retrospectively also visible on MRI. Met-PET/MRI^CR was false negative in one patient, with a cystic adenoma on conventional MRI. Thirteen patients underwent transsphenoidal surgery, with nine achieving full biochemical remission, two clinical improvement and near normalized prolactin levels, and one patient clinical improvement with significant tumour reduction. Hence, nearly all patients (94%) were considered to have a positive outcome. Permanent complication rate was low. Three patients continued DA, two patients have a wait and scan policy.

Conclusion

Met-PET/MRI^CR can provide additional information to guide multidisciplinary preoperative and intraoperative decision making in selected cases of prolactinoma. This approach resulted in a high remission rate with a low rate of complications in our expert centre.

Available only for authorised users

Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A (2006) High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege. Belg J Clin Endocrinol Metab. https://doi.org/10.1210/jc.2006-1668CrossRef

Zamanipoor Najafabadi AH, Zandbergen IM, de Vries F, Broersen LHA, van den Akker-van Marle ME, Pereira AM, Peul WC, Dekkers OM, van Furth WR, Biermasz NR (2020) Surgery as a viable alternative first-line treatment for prolactinoma patients. A systematic review and meta-analysis. J Clin Endocrinol Metab. https://doi.org/10.1210/clinem/dgz144CrossRefPubMedPubMedCentral

Melmed S, Casanueva FF, Hoffman AR, Kleinberg DL, Montori VM, Schlechte JA, Wass JA, Endocrine S (2011) Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. https://doi.org/10.1210/jc.2010-1692CrossRefPubMedPubMedCentral

Klibanski A (2010) Clinical practice. Prolactinomas. N Engl J Med. https://doi.org/10.1056/NEJMcp0912025CrossRefPubMed

Tampourlou M, Trifanescu R, Paluzzi A, Ahmed SK, Karavitaki N (2016) Therapy of endocrine disease: surgery in microprolactinomas: effectiveness and risks based on contemporary literature. Eur J Endocrinol. https://doi.org/10.1530/eje-16-0087CrossRefPubMed

Koulouri O, Steuwe A, Gillett D, Hoole AC, Powlson AS, Donnelly NA, Burnet NG, Antoun NM, Cheow H, Mannion RJ, Pickard JD, Gurnell M (2015) A role for 11C-methionine PET imaging in ACTH-dependent Cushing’s syndrome. Eur J Endocrinol. https://doi.org/10.1530/eje-15-0616CrossRefPubMed

Koulouri O, Kandasamy N, Hoole AC, Gillett D, Heard S, Powlson AS, O’Donovan DG, Annamalai AK, Simpson HL, Akker SA, Aylwin SJ, Brooke A, Buch H, Levy MJ, Martin N, Morris D, Parkinson C, Tysome JR, Santarius T, Donnelly N, Buscombe J, Boros I, Smith R, Aigbirhio F, Antoun NM, Burnet NG, Cheow H, Mannion RJ, Pickard JD, Gurnell M (2016) Successful treatment of residual pituitary adenoma in persistent acromegaly following localisation by 11C-methionine PET co-registered with MRI. Eur J Endocrinol. https://doi.org/10.1530/eje-16-0639CrossRefPubMed

Koulouri O, Hoole AC, English P, Allinson K, Antoun N, Cheow H, Burnet NG, Donnelly N, Mannion RJ, Gurnell M (2016) Localisation of an occult thyrotropinoma with (11)C-methionine PET-CT before and after somatostatin analogue therapy. Lancet Diabetes Endocrinol. https://doi.org/10.1016/s2213-8587(16)30311-4CrossRefPubMed

Bashari WA, Senanayake R, Koulouri O, Gillett D, MacFarlane J, Powlson AS, Fernandez-Pombo A, Bano G, Martin AJ, Scoffings D, Cheow H, Mendichovszky I, Tysome J, Donnelly N, Santarius T, Kolias A, Mannion R, Gurnell M (2020) PET-guided repeat transsphenoidal surgery for previously deemed unresectable lateral disease in acromegaly. Neurosurg Focus. https://doi.org/10.3171/2020.3.Focus2052CrossRefPubMed

10.

Lobatto DJ, Zamanipoor Najafabadi AH, de Vries F, Andela CD, van den Hout WB, Pereira AM, Peul WC, Vliet Vlieland TPM, van Furth WR, Biermasz NR (2019) Toward value based health care in pituitary surgery: application of a comprehensive outcome set in perioperative care. Eur J Endocrinol. https://doi.org/10.1530/eje-19-0344CrossRefPubMed

11.

Wedman J, Pruim J, van der Putten L, Hoekstra OS, de Bree R, van Dijk BAC, van der Laan B (2019) Is C-11 Methionine PET an alternative to 18-F FDG-PET for identifying recurrent laryngeal cancer after radiotherapy? Clin Otolaryngol. https://doi.org/10.1111/coa.13242CrossRefPubMedPubMedCentral

12.

Micko AS, Wöhrer A, Wolfsberger S, Knosp E (2015) Invasion of the cavernous sinus space in pituitary adenomas: endoscopic verification and its correlation with an MRI-based classification. J Neurosurg. https://doi.org/10.3171/2014.12.Jns141083CrossRefPubMed

13.

Knosp E, Steiner E, Kitz K, Matula C (1993) Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery. https://doi.org/10.1227/00006123-199310000-00008CrossRefPubMed

14.

Andereggen L, Frey J, Andres RH, Luedi MM, El-Koussy M, Widmer HR, Beck J, Mariani L, Seiler RW, Christ E (2021) First-line surgery in prolactinomas: lessons from a long-term follow-up study in a tertiary referral center. J Endocrinol Invest. https://doi.org/10.1007/s40618-021-01569-6CrossRefPubMedPubMedCentral

15.

Andereggen L, Frey J, Andres RH, Luedi MM, Gralla J, Schubert GA, Beck J, Mariani L, Christ E (2021) Impact of primary medical or surgical therapy on prolactinoma patients’ BMI and metabolic profile over the long-term. J Clin Transl Endocrinol. https://doi.org/10.1016/j.jcte.2021.100258CrossRefPubMedPubMedCentral

16.

Baussart B, Villa C, Jouinot A, Raffin-Sanson ML, Foubert L, Cazabat L, Bernier M, Bonnet F, Dohan A, Bertherat J, Assie G, Gaillard S (2021) Pituitary surgery as alternative to dopamine agonists treatment for microprolactinomas: a cohort study. Eur J Endocrinol. https://doi.org/10.1530/EJE-21-0293CrossRefPubMed

17.

Chen TY, Lee CH, Yang MY, Shen CC, Yang YP, Chien Y, Huang YF, Lai CM, Cheng WY (2021) Treatment of hyperprolactinemia: a single-institute experience. J Chin Med Assoc. https://doi.org/10.1097/JCMA.0000000000000584CrossRefPubMed

18.

Giese S, Nasi-Kordhishti I, Honegger J (2021) Outcomes of transsphenoidal microsurgery for prolactinomas—a contemporary series of 162 cases. Exp Clin Endocrinol Diabetes. https://doi.org/10.1055/a-1247-4908CrossRefPubMed

19.

Han YL, Chen DM, Zhang C, Pan M, Yang XP, Wu YG (2018) Retrospective analysis of 52 patients with prolactinomas following endoscopic endonasal transsphenoidal surgery. Medicine (Baltimore). https://doi.org/10.1097/MD.0000000000013198CrossRefPubMedPubMedCentral

20.

Lasolle H, Teulade M, Lapras V, Vasiljevic A, Borson-Chazot F, Jouanneau E, Raverot G (2022) Postoperative remission of non-invasive lactotroph pituitary tumor: A single-center experience. Ann Endocrinol (Paris). https://doi.org/10.1016/j.ando.2021.11.008CrossRef

21.

Lu J, Cai L, Wu Z, Lin W, Xu J, Zhu Z, Wang C, Li Q, Su Z (2021) Surgery and medical treatment in microprolactinoma: A systematic review and meta-analysis. Int J Endocrinol. https://doi.org/10.1155/2021/9930059CrossRefPubMedPubMedCentral

22.

Ma Q, Su J, Li Y, Wang J, Long W, Luo M, Liu Q (2018) The chance of permanent cure for micro- and macroprolactinomas, medication or surgery? A systematic review and meta-analysis. Front Endocrinol (Lausanne). https://doi.org/10.3389/fendo.2018.00636CrossRef

23.

Mattogno PP, D’Alessandris QG, Chiloiro S, Bianchi A, Giampietro A, Pontecorvi A, De Marinis L, Olivi A, Anile C, Lauretti L (2021) Reappraising the role of trans-sphenoidal surgery in prolactin-secreting pituitary tumors. Cancers (Basel). https://doi.org/10.3390/cancers13133252CrossRef

24.

Micko A, Vila G, Hoftberger R, Knosp E, Wolfsberger S (2019) Endoscopic transsphenoidal surgery of microprolactinomas: a reappraisal of cure rate based on radiological criteria. Neurosurgery. https://doi.org/10.1093/neuros/nyy385CrossRefPubMed

25.

Park JY, Choi W, Hong AR, Yoon JH, Kim HK, Jang WY, Jung S, Kang HC (2021) Surgery is a safe, effective first-line treatment modality for noninvasive prolactinomas. Pituitary. https://doi.org/10.1007/s11102-021-01168-xCrossRefPubMed

26.

Park K, Park KH, Park HR, Lee JM, Kim YH, Kim DY, Won TB, Kong SH, Kim JH, Shin CS, Paek SH (2021) Long-term outcome of microscopic transsphenoidal surgery for prolactinomas as an alternative to dopamine agonists. J Korean Med Sci. https://doi.org/10.3346/jkms.2021.36.e97CrossRefPubMedPubMedCentral

27.

Penn MC, Cardinal T, Zhang Y, Abt B, Bonney PA, Lorenzo P, Lin M, Rosner J, Weiss M, Zada G, Carmichael JD (2021) Cure and hormonal control after prolactinoma resection: case series and systematic review. J Endocr Soc. https://doi.org/10.1210/jendso/bvab074CrossRefPubMedPubMedCentral

28.

Wei L, Wei X (2021) Outcomes of transsphenoidal surgery in dopamine agonist-resistant prolactinomas: a retrospective study. Hormones (Athens). https://doi.org/10.1007/s42000-021-00309-yCrossRefPubMedCentral

29.

Zielinski G, Ozdarski M, Maksymowicz M, Szamotulska K, Witek P (2020) Prolactinomas: prognostic factors of early remission after transsphenoidal surgery. Front Endocrinol (Lausanne). https://doi.org/10.3389/fendo.2020.00439CrossRef

30.

Cozzi R, Ambrosio MR, Attanasio R, Battista C, Bozzao A, Caputo M, Ciccarelli E, De Marinis L, De Menis E, Faustini Fustini M, Grimaldi F, Lania A, Lasio G, Logoluso F, Losa M, Maffei P, Milani D, Poggi M, Zini M, Katznelson L, Luger A, Poiana C (2022) Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors. Eur J Endocrinol. https://doi.org/10.1530/EJE-21-0977CrossRefPubMedPubMedCentral

31.

Tang BN, Levivier M, Heureux M, Wikler D, Massager N, Devriendt D, David P, Dumarey N, Corvilain B, Goldman S (2006) 11C-methionine PET for the diagnosis and management of recurrent pituitary adenomas. Eur J Nucl Med Mol Imaging. https://doi.org/10.1007/s00259-005-1882-0CrossRefPubMed

32.

Rodriguez-Barcelo S, Gutierrez-Cardo A, Dominguez-Paez M, Medina-Imbroda J, Romero-Moreno L, Arraez-Sanchez M (2014) Clinical usefulness of coregistered 11C-methionine positron emission tomography/3-T magnetic resonance imaging at the follow-up of acromegaly. World Neurosurg. https://doi.org/10.1016/j.wneu.2013.11.011CrossRefPubMed

33.

Muhr C (2006) Positron emission tomography in acromegaly and other pituitary adenoma patients. Neuroendocrinology. https://doi.org/10.1159/000095529CrossRefPubMed

34.

Ikeda H, Abe T, Watanabe K (2010) Usefulness of composite methionine-positron emission tomography/3.0-tesla magnetic resonance imaging to detect the localization and extent of early-stage Cushing adenoma. J Neurosurg. https://doi.org/10.3171/2009.7.Jns09285CrossRefPubMed

35.

Feng Z, He D, Mao Z, Wang Z, Zhu Y, Zhang X, Wang H (2016) Utility of 11C-methionine and 18F-FDG PET/CT in patients with functioning pituitary adenomas. Clin Nucl Med. https://doi.org/10.1097/rlu.0000000000001085CrossRefPubMed

36.

Bergström M, Muhr C, Lundberg PO, Långström B (1991) PET as a tool in the clinical evaluation of pituitary adenomas. J Nucl Med 32:610PubMed

37.

Bergstrom M, Muhr C, Lundberg PO, Bergstrom K, Gee AD, Fasth KJ, Langstrom B (1987) Rapid decrease in amino acid metabolism in prolactin-secreting pituitary adenomas after bromocriptine treatment: a PET study. J Comput Assist Tomogr. https://doi.org/10.1097/00004728-198709000-00014CrossRefPubMed

Title: Implementation of functional imaging using 11C-methionine PET-CT co-registered with MRI for advanced surgical planning and decision making in prolactinoma surgery
Authors: Leontine E. H. Bakker
Marco J. T. Verstegen
Eidrees Ghariq
Berit M. Verbist
Pieter J. Schutte
Waiel A. Bashari
Mark C. Kruit
Alberto M. Pereira
Mark Gurnell
Nienke R. Biermasz
Wouter R. van Furth
Lenka M. Pereira Arias Bouda
Publication date: 26-05-2022
Publisher: Springer US
Keywords: Prolactinoma
Positron Emission Tomography
Dopamine Agonist
Published in: Pituitary / Issue 4/2022
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-022-01230-2

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 4/2022

Prolactin immunoassay: does the high-dose hook effect still exist?

The effect of glucose dynamics on plasma copeptin levels upon glucagon, arginine, and macimorelin stimulation in healthy adults

Lateral orientation of Rathke cleft cysts may be associated with high rates of recurrence after surgery

Preoperative differentiation of hypophysitis and pituitary adenomas using a novel clinicoradiologic scoring system

Pituitary stalk interruption syndrome: phenotype, predictors, and pathophysiology of perinatal events

Predictive value of macular ganglion cell-inner plexiform layer thickness in visual field defect of pituitary adenoma patients: a case-control study

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials