{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:33:13Z","timestamp":1789475593635,"version":"build-2803163510"},"reference-count":28,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T00:00:00Z","timestamp":1738022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Doctoral Fellowship of the Belgian Fonds National de la Recherche Scientifique"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Equivocal or negative pituitary magnetic resonance imaging (MRI) findings pose a significant challenge in the management of persistent or recurrent Cushing disease (CD), compromising the chances of success of further transsphenoidal surgery (TSS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine the diagnostic utility of 11C-methionine (11C-MET) positron emission tomography\/computerized tomography (PET\/CT) in localizing residual or relapsing corticotroph adenoma.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We retrospectively analyzed the results of all 11C-MET PET\/CT performed at 2 tertiary medical centers between May 2002 and November 2023 in 22 patients with persistent\/recurrent CD after initial TSS and equivocal\/negative pituitary MRI. In 15 cases, 11C-MET PET\/CT images were also co-registered with high-resolution 3D T1 or FLAIR MRI pituitary imaging.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 22 patients (18 female; mean age 36 years at diagnosis; mean initial tumor maximum diameter 6.5\u2005mm), 13 had a suspect anomaly on conventional MRI and 9 had a negative MRI. Maximal metabolic activity in the suspect area (SUVmaxT) was found in 14 patients (63.5%; 5\/9 patients with negative pituitary MRI and 9\/13 with equivocal findings). Based on positive imaging, 12 patients underwent repeat TSS, successful in 7, while 2 patients underwent Gamma Knife radiosurgery (GKRS), both resulting in remission (total remission rate of 64%). Among the 5 patients not cured by TSS, the presence of corticotroph adenoma in the resected tissue was found in 3 cases. Positive 11C-MET PET\/CT had a detection rate accuracy of 86% (12\/14). Of the 8 PET-negative patients, 2 underwent exploratory TSS, with no remission, and 2 underwent GKRS, with 1 long-term remission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>11C-MET PET\/CT imaging can provide valuable diagnostic information to detect a corticotroph microadenoma in more than half of patients with persistent\/recurrent CD and equivocal or negative MRI findings, allowing targeted TSS or radiosurgery with a global success rate of 64% in the selected subgroup with positive imaging.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf047","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T07:42:19Z","timestamp":1738050139000},"page":"2845-2852","source":"Crossref","is-referenced-by-count":16,"title":["Diagnostic Value of 11C-Methionine PET-CT Imaging in Persistent or Recurrent Cushing Disease After Surgery"],"prefix":"10.1210","volume":"110","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5706-0504","authenticated-orcid":false,"given":"Raluca Maria","family":"Furnica","sequence":"first","affiliation":[{"name":"Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc UCL , 1200 Bruxelles ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"France","family":"Devuyst","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Universit\u00e9 libre de Bruxelles (ULB), H\u00f4pital Universitaire de Bruxelles (HUB), CUB H\u00f4pital Erasme , 1070 Bruxelles ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Mathey","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and PET\/Biomedical Cyclotron Unit, Universit\u00e9 libre de Bruxelles (ULB), H\u00f4pital Universitaire de Bruxelles (HUB), CUB H\u00f4pital Erasme , 1070 Bruxelles ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan Matei","family":"Constantinescu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc UCL , 1200 Bruxelles ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlien","family":"De Herdt","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Diabetology and Metabolism, University Antwerpen , 2650 Edegem ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orsalia","family":"Alexopoulou","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc UCL , 1200 Bruxelles ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renaud","family":"Lhommel","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc UCL , 1200 Bruxelles ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Maiter","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Nutrition, Cliniques Universitaires Saint-Luc UCL , 1200 Bruxelles ,","place":["Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2025,1,28]]},"reference":[{"issue":"5","key":"2025091917011994000_dgaf047-B1","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1007\/s11102-018-0893-3","article-title":"Endoscopic vs. microscopic transsphenoidal surgery for Cushing's disease: a systematic review and meta-analysis","volume":"21","author":"Broersen","year":"2018","journal-title":"Pituitary"},{"key":"2025091917011994000_dgaf047-B2","doi-asserted-by":"crossref","first-page":"1090144","DOI":"10.3389\/fendo.2022.1090144","article-title":"The clinical outcomes of imaging 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