{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:36:04Z","timestamp":1783654564969,"version":"3.55.0"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":["eje.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>We report our experience of functional imaging with<jats:sup>11<\/jats:sup>C-methionine positron emission tomography\u2013computed tomography (PET\u2013CT) co-registered with 3D gradient echo (spoiled gradient recalled (SPGR)) magnetic resonance imaging (MRI) in the investigation of ACTH-dependent Cushing's syndrome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Twenty patients with i)<jats:italic>de novo<\/jats:italic>Cushing's disease (CD,<jats:italic>n<\/jats:italic>=10), ii) residual or recurrent hypercortisolism following first pituitary surgery (\u00b1radiotherapy;<jats:italic>n<\/jats:italic>=8) or iii) ectopic Cushing's syndrome (<jats:italic>n<\/jats:italic>=2) were referred to our centre for functional imaging studies between 2010 and 2015. Six of the patients with<jats:italic>de novo<\/jats:italic>CD and five of those with persistent\/relapsed disease had a suspected abnormality on conventional MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients underwent<jats:sup>11<\/jats:sup>C-methionine PET\u2013CT. For pituitary imaging, co-registration of PET\u2013CT images with contemporaneous SPGR MRI (1\u200amm slice thickness) was performed, followed by detailed mapping of<jats:sup>11<\/jats:sup>C-methionine uptake across the sella in three planes (coronal, sagittal and axial). This allowed us to determine whether suspected adenomas seen on structural imaging exhibited focal tracer uptake on functional imaging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In seven of ten patients with<jats:italic>de novo<\/jats:italic>CD, asymmetric<jats:sup>11<\/jats:sup>C-methionine uptake was observed within the sella, which co-localized with the suspected site of a corticotroph microadenoma visualised on SPGR MRI (and which was subsequently confirmed histologically following successful transsphenoidal surgery (TSS)). Focal<jats:sup>11<\/jats:sup>C-methionine uptake that correlated with a suspected abnormality on pituitary MRI was seen in five of eight patients with residual or recurrent Cushing's syndrome following first TSS (and pituitary radiotherapy in two cases). Two patients elected to undergo repeat TSS with histology confirming a corticotroph tumour in each case. In two patients with the ectopic ACTH syndrome,<jats:sup>11<\/jats:sup>C-methionine was concentrated in sites of distant metastases, with minimal uptake in the sellar region.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:sup>11<\/jats:sup>C-methionine PET\u2013CT can aid the detection of ACTH-secreting tumours in Cushing's syndrome and facilitate targeted therapy.<\/jats:p><\/jats:sec>","DOI":"10.1530\/eje-15-0616","type":"journal-article","created":{"date-parts":[[2015,8,6]],"date-time":"2015-08-06T02:09:17Z","timestamp":1438826957000},"page":"M107-M120","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-1","source":"Crossref","is-referenced-by-count":96,"title":["A role for 11C-methionine PET imaging in ACTH-dependent Cushing's syndrome"],"prefix":"10.1093","volume":"173","author":[{"given":"Olympia","family":"Koulouri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Steuwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gillett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew C","family":"Hoole","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew S","family":"Powlson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil A","family":"Donnelly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil G","family":"Burnet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nagui M","family":"Antoun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heok","family":"Cheow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J","family":"Mannion","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D","family":"Pickard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Gurnell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","reference":[{"key":"2015090318131268000_173.4.M107.1","doi-asserted-by":"publisher","DOI":"10.3171\/JNS\/2008\/109\/10\/0751"},{"key":"2015090318131268000_173.4.M107.2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2002.01511.x"},{"key":"2015090318131268000_173.4.M107.3","doi-asserted-by":"publisher","DOI":"10.1097\/00006123-200003000-00005"},{"key":"2015090318131268000_173.4.M107.4","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-120-10-199405150-00001"},{"key":"2015090318131268000_173.4.M107.5","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20412"},{"key":"2015090318131268000_173.4.M107.6","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2002-021438"},{"key":"2015090318131268000_173.4.M107.7","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2013-2309"},{"key":"2015090318131268000_173.4.M107.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199109263251301"},{"key":"2015090318131268000_173.4.M107.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2005.01.059"},{"key":"2015090318131268000_173.4.M107.10","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2012-3943"},{"key":"2015090318131268000_173.4.M107.11","unstructured":"Bergstr\u00f6m M Muhr C Lundberg PO L\u00e5ngstr\u00f6m B . 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