Imperial College London
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Professor Niamh Martin

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Professor of Endocrinology
 
 
 
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Contact

 

n.martin

 
 
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Location

 

6N5Commonwealth BuildingHammersmith Campus

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Summary

 

Publications

Citation

BibTex format

@article{Koulouri:2016:10.1530/EJE-16-0639,
author = {Koulouri, O and Kandasamy, N and Hoole, AC and Gillett, D and Heard, S and Powlson, AS and O'Donovan, DG and Annamalai, AK and Simpson, H and Akker, SA and Aylwin, S and Brooke, A and Buch, H and Levy, M and Martin, NM and Morris, D and Parkinson, C and Tysome, JR and Santarius, T and Donnelly, NA and Buscombe, J and Boros, I and Smith, R and Aigbirhio, F and Antoun, NM and Burnet, NG and Cheow, H and Mannion, RJ and Pickard, JD and Gurnell, M},
doi = {10.1530/EJE-16-0639},
journal = {European Journal of Endocrinology},
pages = {485--498},
title = {Successful treatment of residual pituitary adenoma in persistent acromegaly following localisation by 11C-methionine PET co-registered with MRI},
url = {http://dx.doi.org/10.1530/EJE-16-0639},
volume = {175},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - OBJECTIVE: To determine if functional imaging using (11)C-methionine positron emission tomography computed tomography, co-registered with 3D gradient echo MRI (Met-PET/MRI), can identify sites of residual active tumour in treated acromegaly, and discriminate these from post-treatment change, to allow further targeted treatment. DESIGN/METHODS: Twenty-six patients with persistent acromegaly following previous treatment, in whom MRI appearances were considered indeterminate, were referred to our centre for further evaluation over a 4.5-year period. Met-PET/MRI was performed in each case and findings were used to inform decision-making regarding adjunctive therapy. Four patients with clinical and biochemical remission post-transsphenoidal surgery (TSS), but in whom residual tumour was suspected on postoperative MRI, were also studied. RESULTS: Met-PET/MRI demonstrated tracer uptake only within the normal gland in the four patients who had achieved complete remission following primary surgery. In contrast, in 26 patients with active acromegaly, Met-PET/MRI localised sites of abnormal tracer uptake in all but one case. Based on these findings, fourteen subjects underwent endoscopic TSS, leading to a marked improvement in (n=7), or complete resolution of (n=7), residual acromegaly. One patient received stereotactic radiosurgery and two patients with cavernous sinus invasion were treated with image-guided fractionated radiotherapy, with good disease control. Three subjects await further intervention. Five patients chose to receive adjunctive medical therapy. Only one patient developed additional pituitary deficits following Met-PET/MRI-guided TSS. CONCLUSIONS: In patients with persistent acromegaly following primary therapy, Met-PET/MRI can help identify the site(s) of residual pituitary adenoma when MRI appearances are inconclusive, and direct further targeted intervention (surgery or radiotherapy).
AU  - Koulouri,O
AU  - Kandasamy,N
AU  - Hoole,AC
AU  - Gillett,D
AU  - Heard,S
AU  - Powlson,AS
AU  - O'Donovan,DG
AU  - Annamalai,AK
AU  - Simpson,H
AU  - Akker,SA
AU  - Aylwin,S
AU  - Brooke,A
AU  - Buch,H
AU  - Levy,M
AU  - Martin,NM
AU  - Morris,D
AU  - Parkinson,C
AU  - Tysome,JR
AU  - Santarius,T
AU  - Donnelly,NA
AU  - Buscombe,J
AU  - Boros,I
AU  - Smith,R
AU  - Aigbirhio,F
AU  - Antoun,NM
AU  - Burnet,NG
AU  - Cheow,H
AU  - Mannion,RJ
AU  - Pickard,JD
AU  - Gurnell,M
DO  - 10.1530/EJE-16-0639
EP  - 498
PY  - 2016///
SN  - 1479-683X
SP  - 485
TI  - Successful treatment of residual pituitary adenoma in persistent acromegaly following localisation by 11C-methionine PET co-registered with MRI
T2  - European Journal of Endocrinology
UR  - http://dx.doi.org/10.1530/EJE-16-0639
UR  - http://hdl.handle.net/10044/1/41740
VL  - 175
ER  -
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