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Vol. 27, Art. 35 (pp. 846-869)    |    2026       

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Pathomorphological rationale for using 18f-fluorodeoxyglucose pet-ct for the diagnosis of pituitary adenoma

Guseva K.A., Tsoi U. A., Ryzhkova D.V., Mitrofanova L.B.
Federal State Budgetary Institution "Almazov National Medical Research Centre" of the Ministry of Health of the Russian Federation, 197341, Russian Federation, St. Petersburg, 2 Akkuratova Street

Brief summary

Introduction. Positron emission tomography/computed tomography is not currently a widely used method for diagnosing pituitary adenomas, but potential applications are being considered, in particular for visualizing microadenomas that are not visible on magnetic resonance images, as well as for detecting residual tumor fragments and early detection of relapses. Objective. Morphological assessment of the validity of pituitary microadenomas diagnosis using positron emission tomography/computed tomography with 18F-Fluorodeoxyglucose. Materials and methods. Histological and immunohistochemical examination of the surgical material of pituitary adenomas with the GLUT-1 marker: 3 prolactinomas, 10 corticotropinomas, 3 null-cell adenomas, 4 somatotropinomas, and 6 normal pituitary glands (autopsy material). All patients with corticotropinomas and somatotropinomas underwent combined positron emission and computed tomography with 18F-Fluorodeoxyglucose. Results. Immunohistochemical study with GLUT1 antibody in the group with prolactinomas showed staining of tumor cells in 1 case out of 3; in the group with corticotropinomas staining was observed in 8 cases out of 10. All patients from this group underwent positron emission tomography/computed tomography with 18F-Fluorodeoxyglucose in addition to magnetic resonance imaging at the preoperative stage, which confirmed the diagnosis of microadenoma. In the groups with null-cell adenomas and somatotropinomas, tumor cell staining was not detected. In the group with somatotropinomas, a positron emission tomography/computed tomography with 18F-Fluorodeoxyglucose scan was also performed, which confirmed the diagnosis of microadenoma. Statistical analysis revealed a significant difference in GLUT1 expression in groups with different types of adenomas, with GLUT1 expression predominating in corticotropinomas; it also revealed a significant difference in GLUT1 expression in the group with corticotropinomas and adenohypophysis without pathology, with GLUT1 expression predominating in corticotropinomas. Conclusions. The obtained results morphologically justify the use of positron emission tomography/computed tomography with 18F-Fluorodeoxyglucose only in individuals with suspected microcorticotropinoma


Key words

corticotropinoma; prolactinoma; somatotropinoma; null cell adenoma; positron emission tomography; 18F-FDG.

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