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Pre‐ and postoperative 68 Ga‐DOTATOC positron emission tomography for hormone‐secreting pituitary neuroendocrine tumours
Author(s) -
Tjörnstrand Axel,
CasarBorota Olivera,
Heurling Kerstin,
Schöll Michael,
Gjertsson Peter,
Ragnarsson Oskar,
Filipsson Nyström Helena
Publication year - 2021
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14425
Subject(s) - somatostatin , medicine , pituitary gland , standardized uptake value , corticotropic cell , positron emission tomography , somatostatin receptor , somatostatin receptor 2 , somatotropic cell , endocrinology , nuclear medicine , hormone
Objectives Somatostatin receptors (SSTRs) are potential targets for detecting pituitary neuroendocrine tumours (PitNETs) that can be visualized effectively with 68 Ga‐labelled PET tracers. With this study, we have evaluated the diagnostic properties of such a tracer, 68 Ga‐DOTATOC, in patients with hormone‐producing PitNETs before and after surgery. Design/Methods This prospective case‐control study presents preoperative positron emission tomography (PET) and histopathological data in 18 patients with somatotroph ( n = 8), corticotroph ( n = 7) and thyrotroph ( n = 3) PitNETs. Patients were scanned pre‐ and postoperatively with 68 Ga‐DOTATOC PET. For the postoperative part of the study, patients with gonadotroph tumours ( n = 7) were also included. Fifteen pituitary healthy controls underwent the same protocol once. The maximum standard uptake value (SUV max ) was analysed in manually outlined regions around the tumour in patients and around the pituitary gland in controls. specimens were collected during surgery in subjects for assessment of adenohypophyseal tumour cell type and the SSTR expression. Results Thyrotroph tumours showed higher uptake (median SUV max 41.1; IQR 37.4‐60.0) and corticotroph tumours lower uptake (SUV max 6.8; 2.6‐9.3) than normal pituitary gland (SUV max 13.8; 12.1‐15.5). The uptake in somatotroph tumours (SUV max 15.9; 11.6‐19.7) was similar to the uptake in the pituitary gland. There was a strong correlation between SUV max and SSTR2 expression (r = .75 ( P < .01)). In the postoperative evaluation, PET was able to correlate tracer uptake with biochemical cure and noncure in patients with an abnormal postoperative magnetic resonance image and a preoperative tumour uptake SUV max > 13.8. Conclusions 68 Ga‐DOTATOC PET can be used to detect thyrotroph tumours in the pre‐ and postoperative imaging assessment. Corticotroph tumours had a significantly lower uptake compared to the pituitary gland but without a distinct increased tumour uptake the clinical postoperative value is limited.