Incidental Pituitary Uptake on 18F-fluorodeoxyglucose positron emission tomography: Clinical Implications and characteristics
Abstract
Background/aim: Positron emission tomography (PET)/CT using 18F-fluorodeoxyglucose (FDG) is a commonly used technique for staging and/or localization in various malignant diseases. Our study aimed to investigate the clinical laboratory and histopathological features of patients with incidental pituitary involvement.
Materials and methods: In this retrospective study, approximately 60,000 18-FDG PET/CT scans performed for various indications between May 2012 and December 2020 were reviewed to identify patients with pituitary involvement. The clinical and laboratory characteristics of these patients were investigated using the Hospital Information Management System.
Results: Twenty-five patients with incidental pituitary uptake were identified on 18F-FDG PET/CT scans. Eleven patients had macroadenomas. The mean SUVmax levels of the pituitary lesions and different malignancies were statistically similar (13.6 (5.40–38.80) and 11.7 (0.00–116.0), respectively. Six of the 25 patients had nonfunctional adenomas, one patient had a prolactinoma, and four patients had pituitary insufficiency based on hormonal evaluation. Two patients were found to have a pituitary adenoma on histopathological evaluation. One patient had a metastasis from lung carcinoma, as detected radiologically.
Conclusion: Incidental pituitary uptake is often overlooked, particularly in the patients with advanced metastatic disease. In individuals with a primary malignancy who are subjected to significant physiological stress from chemotherapy, surgery, and other interventions, timely diagnosing and management of pituitary insufficiency is crucial, as it can significantly impact morbidity and mortality. To develop diagnostic algorithms, predictive models, or systematic follow-up strategies, prospective studies are needed that include hormonal, radiological, and histopathological follow-up data on both the primary malignancy and pituitary metastases.
Keywords
18F-fluorodeoxyglucose positron emission tomography, pituitary uptake, malignancy
Supporting Institution
none
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