⁶⁸Ga-Pentixafor PET/MRI for identifying corticotroph adenomas in Cushing disease: a pilot study.

IF 3.8 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Pituitary Pub Date : 2026-10-16 DOI:10.1007/s11102-026-01770-x

Rodrigo Fano, Anton Nosov, Burcin Agridag Ucpinar, Simone Krebs, Serge Lyashchenko, Angeliki Theodorou, Andrew L Lin, Viviane Tabar, Heiko Schoder, Eliza B Geer

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引用次数: 0

Abstract

Purpose: To assess whether C-X-C motif chemokine receptor 4-targeted ⁶⁸Ga-Pentixafor PET/MRI can localize corticotroph adenomas in patients with Cushing disease (CD), particularly when MRI is negative or inconclusive, and explore performance in newly diagnosed versus persistent/recurrent disease.

Methods: In this single-center pilot study, 10 patients with newly diagnosed or persistent/recurrent CD, confirmed by inferior petrosal sinus sampling (IPSS) and/or surgical pathology, underwent ⁶⁸Ga-Pentixafor PET/MRI. Clinical, biochemical, radiologic, surgical, and postoperative data were reviewed. ⁶⁸Ga-Pentixafor PET/MRI were classified as positive or negative using visual and quantitative assessment, including maximum standardized uptake values (SUVmax) and target-to-background (SUVmean of the blood pool in the cavernous sinus) ratio (TBR).

Results: Participants had a mean age of 46.7 years; 9 were female. Five had newly diagnosed and 5 had persistent/recurrent CD. Two scans showed focal pituitary ⁶⁸Ga-Pentixafor uptake compared to background pituitary tissue. One was confirmed by an MRI-visible lesion, positive pathology, and postoperative remission. The second occurred with an inconclusive MRI, negative pathology, and persistent postoperative disease; however, IPSS centralized. Three patients with negative scans underwent surgery and achieved remission, indicating false-negative imaging. Among 5 patients with negative scans who did not undergo subsequent surgery, 4 had persistent/recurrent CD and 1 had newly diagnosed CD treated medically.

Conclusion: In this pilot cohort, ⁶⁸Ga-Pentixafor PET/MRI showed limited and variable performance for corticotroph adenoma localization. Although it may provide complementary information in selected patients with MRI-visible or equivocal lesions, further study is needed before it can be incorporated into diagnostic algorithms or considered an alternative to IPSS.

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68Ga-Pentixafor PET/MRI鉴别库欣病皮质性腺瘤的初步研究

目的：评估C-X-C基序趋化因子受体4靶向68Ga-Pentixafor PET/MRI是否可以定位库欣病（CD）患者的皮质性腺瘤，特别是当MRI阴性或不确定时，并探讨新诊断与持续/复发疾病的表现。方法：在这项单中心先导研究中，10例经下岩窦取样（IPSS）和/或手术病理证实的新诊断或持续性/复发性CD患者接受了68Ga-Pentixafor PET/MRI检查。我们回顾了临床、生化、放射学、外科和术后的资料。68Ga-Pentixafor PET/MRI通过视觉和定量评估分为阳性或阴性，包括最大标准化摄取值（SUVmax）和靶-背景（海绵窦血池SUVmean）比（TBR）。结果：参与者的平均年龄为46.7岁；9名女性。5例为新诊断，5例为持续性/复发性CD。两次扫描显示局灶性垂体68ga - pentxafor摄取与垂体背景组织相比。1例通过mri可见病变、病理阳性和术后缓解证实。第二例出现MRI不确定，病理阴性，术后疾病持续；然而，IPSS集中。三名扫描呈阴性的患者接受了手术并获得了缓解，表明假阴性成像。在5名未接受后续手术的阴性扫描患者中，4名患有持续性/复发性乳糜泻，1名新诊断的乳糜泻接受了医学治疗。结论：在该先导队列中，68ga - pentixapet /MRI在促皮质腺瘤定位中的表现有限且不稳定。虽然它可以为mri可见或模糊病变的特定患者提供补充信息，但在将其纳入诊断算法或考虑替代IPSS之前，还需要进一步的研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pituitary 医学-内分泌学与代谢

CiteScore

7.10

自引率

7.90%

发文量

审稿时长

6 months

期刊介绍： Pituitary is an international publication devoted to basic and clinical aspects of the pituitary gland. It is designed to publish original, high quality research in both basic and pituitary function as well as clinical pituitary disease. The journal considers: Biology of Pituitary Tumors Mechanisms of Pituitary Hormone Secretion Regulation of Pituitary Function Prospective Clinical Studies of Pituitary Disease Critical Basic and Clinical Reviews Pituitary is directed at basic investigators, physiologists, clinical adult and pediatric endocrinologists, neurosurgeons and reproductive endocrinologists interested in the broad field of the pituitary and its disorders. The Editorial Board has been drawn from international experts in basic and clinical endocrinology. The journal offers a rapid turnaround time for review of manuscripts, and the high standard of the journal is maintained by a selective peer-review process which aims to publish only the highest quality manuscripts. Pituitary will foster the publication of creative scholarship as it pertains to the pituitary and will provide a forum for basic scientists and clinicians to publish their high quality pituitary-related work.