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Functional imaging, specifically PET has matured into a problem-solving modality when conventional imaging is equivocal, provided it is used selectively and interpreted within a physiology-led framework. This review proposes an MRI-first, tiered imaging strategy and a pragmatic approach to tracer selection from the available armamentarium ([\n                    <jats:sup>11<\/jats:sup>\n                    C]methionine, [\n                    <jats:sup>68<\/jats:sup>\n                    \u00a0Ga]SSTR ligands, [\n                    <jats:sup>68<\/jats:sup>\n                    \u00a0Ga]PentixaFor, [\n                    <jats:sup>18<\/jats:sup>\n                    F]FET and [\n                    <jats:sup>18<\/jats:sup>\n                    F]FDG). We emphasise how to optimise PET acquisition and reporting, and how to integrate imaging with endocrine phenotype, treatment history and surgical\/radiosurgical planning to maximise clinical impact while safeguarding pituitary function.\n                  <\/jats:p>","DOI":"10.1007\/s11154-026-10063-4","type":"journal-article","created":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T07:03:10Z","timestamp":1781679790000},"page":"1059-1076","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Functional pituitary adenoma imaging"],"prefix":"10.1007","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9578-011X","authenticated-orcid":false,"given":"Linus","family":"Hesse","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4464-0427","authenticated-orcid":false,"given":"Linus","family":"Haberbosch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,17]]},"reference":[{"issue":"10","key":"10063_CR1","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1038\/s41574-025-01134-8","volume":"21","author":"M Fleseriu","year":"2025","unstructured":"Fleseriu M, Gurnell M, McCormack A, Fukuoka H, Glezer A, Langlois F, et al. 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