Leontine E. H. Bakker, Marco J. T. Verstegen, Diandra C. Manole, Huangling Lu, Thomas J. M. Decramer, Iris C. M. Pelsma, Mark C. Kruit, Berit M. Verbist, Annenienke van de Ven, Mark Gurnell, Idris Ghariq, Wouter R. van Furth, Nienke R. Biermasz, Lenka M. Pereira Arias-Bouda
{"title":"持续性肢端肥大症患者的 18F- 氟-乙基-酪氨酸 PET 与核磁共振成像联合登记。","authors":"Leontine E. H. Bakker, Marco J. T. Verstegen, Diandra C. Manole, Huangling Lu, Thomas J. M. Decramer, Iris C. M. Pelsma, Mark C. Kruit, Berit M. Verbist, Annenienke van de Ven, Mark Gurnell, Idris Ghariq, Wouter R. van Furth, Nienke R. Biermasz, Lenka M. Pereira Arias-Bouda","doi":"10.1111/cen.15079","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To report our experience with <sup>18</sup>F-fluoro-ethyl-tyrosine (FET) positron emission tomography-computed tomography (PET-CT) co-registered with magnetic resonance imaging (MRI) (FET-PET/MRI<sup>CR</sup>) in the care trajectory for persistent acromegaly.</p>\n </section>\n \n <section>\n \n <h3> Design</h3>\n \n <p>Prospective case series.</p>\n </section>\n \n <section>\n \n <h3> Patients</h3>\n \n <p>Ten patients with insufficiently controlled acromegaly referred to our team to evaluate surgical options.</p>\n </section>\n \n <section>\n \n <h3> Measurements</h3>\n \n <p>FET-PET/MRICR was used to support decision-making if MRI alone and multidisciplinary team evaluation did not provide sufficient clarity to proceed to surgery.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>FET-PET/MRI<sup>CR</sup> showed suspicious (para)sellar tracer uptake in all patients. In five patients FET-PET/MRI<sup>CR</sup> was fully concordant with conventional MRI, and in one patient partially concordant. FET-PET/MRI<sup>CR</sup> identified suggestive new foci in four other patients. Surgical re-exploration was performed in nine patients (aimed at total resection (6), debulking (2), diagnosis (1)), and one patient underwent radiation therapy. In 7 of 9 (78%) operated patients FET-PET/MRI<sup>CR</sup> findings were confirmed intraoperatively, and in six (67%) also histologically. IGF-1 decreased significantly in eight patients (89%). All patients showed clinical improvement. Complete biochemical remission was achieved in three patients (50% of procedures in which total resection was anticipated feasible). Biochemistry improved in five and was unchanged in one patient. No permanent complications occurred. At six months, optimal outcome (preoperative intended goal achieved without permanent complications) was achieved in six (67%) patients and an intermediate outcome (goal not achieved, but no complications) in the other three patients.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>In patients with persisting acromegaly without a clear surgical target on MRI, FET-PET/MRI<sup>CR</sup> is a new tracer to provide additional information to aid decision-making by the multidisciplinary pituitary team.</p>\n </section>\n </div>","PeriodicalId":10346,"journal":{"name":"Clinical Endocrinology","volume":null,"pages":null},"PeriodicalIF":3.0000,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15079","citationCount":"0","resultStr":"{\"title\":\"18F-fluoro-ethyl-tyrosine PET co-registered with MRI in patients with persisting acromegaly\",\"authors\":\"Leontine E. H. Bakker, Marco J. T. Verstegen, Diandra C. Manole, Huangling Lu, Thomas J. M. Decramer, Iris C. M. Pelsma, Mark C. Kruit, Berit M. Verbist, Annenienke van de Ven, Mark Gurnell, Idris Ghariq, Wouter R. van Furth, Nienke R. Biermasz, Lenka M. Pereira Arias-Bouda\",\"doi\":\"10.1111/cen.15079\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To report our experience with <sup>18</sup>F-fluoro-ethyl-tyrosine (FET) positron emission tomography-computed tomography (PET-CT) co-registered with magnetic resonance imaging (MRI) (FET-PET/MRI<sup>CR</sup>) in the care trajectory for persistent acromegaly.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Design</h3>\\n \\n <p>Prospective case series.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Patients</h3>\\n \\n <p>Ten patients with insufficiently controlled acromegaly referred to our team to evaluate surgical options.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Measurements</h3>\\n \\n <p>FET-PET/MRICR was used to support decision-making if MRI alone and multidisciplinary team evaluation did not provide sufficient clarity to proceed to surgery.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>FET-PET/MRI<sup>CR</sup> showed suspicious (para)sellar tracer uptake in all patients. In five patients FET-PET/MRI<sup>CR</sup> was fully concordant with conventional MRI, and in one patient partially concordant. FET-PET/MRI<sup>CR</sup> identified suggestive new foci in four other patients. Surgical re-exploration was performed in nine patients (aimed at total resection (6), debulking (2), diagnosis (1)), and one patient underwent radiation therapy. In 7 of 9 (78%) operated patients FET-PET/MRI<sup>CR</sup> findings were confirmed intraoperatively, and in six (67%) also histologically. IGF-1 decreased significantly in eight patients (89%). All patients showed clinical improvement. Complete biochemical remission was achieved in three patients (50% of procedures in which total resection was anticipated feasible). Biochemistry improved in five and was unchanged in one patient. No permanent complications occurred. At six months, optimal outcome (preoperative intended goal achieved without permanent complications) was achieved in six (67%) patients and an intermediate outcome (goal not achieved, but no complications) in the other three patients.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>In patients with persisting acromegaly without a clear surgical target on MRI, FET-PET/MRI<sup>CR</sup> is a new tracer to provide additional information to aid decision-making by the multidisciplinary pituitary team.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10346,\"journal\":{\"name\":\"Clinical Endocrinology\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2024-05-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/cen.15079\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Endocrinology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/cen.15079\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"ENDOCRINOLOGY & METABOLISM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Endocrinology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/cen.15079","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
18F-fluoro-ethyl-tyrosine PET co-registered with MRI in patients with persisting acromegaly
Objective
To report our experience with 18F-fluoro-ethyl-tyrosine (FET) positron emission tomography-computed tomography (PET-CT) co-registered with magnetic resonance imaging (MRI) (FET-PET/MRICR) in the care trajectory for persistent acromegaly.
Design
Prospective case series.
Patients
Ten patients with insufficiently controlled acromegaly referred to our team to evaluate surgical options.
Measurements
FET-PET/MRICR was used to support decision-making if MRI alone and multidisciplinary team evaluation did not provide sufficient clarity to proceed to surgery.
Results
FET-PET/MRICR showed suspicious (para)sellar tracer uptake in all patients. In five patients FET-PET/MRICR was fully concordant with conventional MRI, and in one patient partially concordant. FET-PET/MRICR identified suggestive new foci in four other patients. Surgical re-exploration was performed in nine patients (aimed at total resection (6), debulking (2), diagnosis (1)), and one patient underwent radiation therapy. In 7 of 9 (78%) operated patients FET-PET/MRICR findings were confirmed intraoperatively, and in six (67%) also histologically. IGF-1 decreased significantly in eight patients (89%). All patients showed clinical improvement. Complete biochemical remission was achieved in three patients (50% of procedures in which total resection was anticipated feasible). Biochemistry improved in five and was unchanged in one patient. No permanent complications occurred. At six months, optimal outcome (preoperative intended goal achieved without permanent complications) was achieved in six (67%) patients and an intermediate outcome (goal not achieved, but no complications) in the other three patients.
Conclusions
In patients with persisting acromegaly without a clear surgical target on MRI, FET-PET/MRICR is a new tracer to provide additional information to aid decision-making by the multidisciplinary pituitary team.
期刊介绍：
Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
