{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T18:08:37Z","timestamp":1781719717057,"version":"3.54.5"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,4]]},"abstract":"\n Object<\/jats:title>\n Fifty to eighty percent of Cushing disease is diagnosed by typical endocrine responses. Recently, the number of diagnoses of Cushing disease without typical Cushing syndrome has been increasing; therefore, improving ways to determine the localization of the adenoma and making an early diagnosis is important. This study was undertaken to determine the present diagnostic accuracy for Cushing microadenoma and to compare the differences in diagnostic accuracy between MR imaging and PET\/MR imaging.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n During the past 3 years the authors analyzed the diagnostic accuracy in a series of 35 patients with Cushing adenoma that was verified by surgical pituitary exploration. All 35 cases of Cushing disease, including 20 cases of \u201covert\u201d and 15 cases of \u201cpreclinical\u201d Cushing disease, were studied. Superconductive MR images (1.5 or 3.0 T) and composite images from FDG-PET or methionine (MET)\u2013PET and 3.0-T MR imaging were compared with the localization of adenomas verified by surgery.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The diagnostic accuracy of superconductive MR imaging for detecting the localization of Cushing microadenoma was only 40%. The causes of unsatisfactory results for superconductive MR imaging were false-negative results (10 cases), false-positive results (6 cases), and instances of double pituitary adenomas (3 cases). In contrast, the accuracy of microadenoma localization using MET-PET\/3.0-T MR imaging was 100% and that of FDG-PET\/3.0-T MR imaging was 73%. Moreover, the adenoma location was better delineated on MET-PET\/MR images than on FDG-PET\/MR images. There was no significant difference in maximum standard uptake value of adenomas evaluated by MET-PET between preclinical Cushing disease and overt Cushing disease.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Composite MET-PET\/3.0-T MR imaging is useful for the improvement of the delineation of Cushing microadenoma and offers high-quality detectability for early-stage Cushing adenoma.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2009.7.jns09285","type":"journal-article","created":{"date-parts":[[2009,8,21]],"date-time":"2009-08-21T12:51:20Z","timestamp":1250859080000},"page":"750-755","source":"Crossref","is-referenced-by-count":61,"title":["Usefulness of composite methionine\u2013positron emission tomography\/3.0-tesla magnetic resonance imaging to detect the localization and extent of early-stage Cushing adenoma"],"prefix":"10.3171","volume":"112","author":[{"given":"Hidetoshi","family":"Ikeda","sequence":"first","affiliation":[{"name":"Research Institute for Pituitary Disease,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiko","family":"Abe","sequence":"additional","affiliation":[{"name":"Department of Radiology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Research Institute for Neuroscience, Southern Tohoku General Hospital, Koriyama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1120750","series-title":"J Clin Endocrinol Metab","first-page":"5593","article-title":"Diagnosis and complications of Cushing's syndrome: a consensus statement","volume":"88","author":"Arnaldi","year":"2003"},{"key":"b2-1120750","series-title":"J Clin Endocrinol Metab","first-page":"1780","article-title":"Effectiveness versus efficacy: the limited value in clinical practice of high dose dexamethasone suppression testing in the differential diagnosis of adrenocorticotropin-dependent Cushing's syndrome","volume":"82","author":"Aron","year":"1997"},{"key":"b3-1120750","series-title":"J Clin Endocrinol Metab","first-page":"5134","article-title":"Detection of ACTH-secreting pituitary adenomas by magnetic resonance imaging in children and adolescents with Cushing's disease","volume":"90","author":"Batista","year":"2005"},{"key":"b4-1120750","series-title":"Arch Intern Med","first-page":"3045","article-title":"The diagnosis of Cushing's syndrome","volume":"160","author":"Boscaro","year":"2000"},{"key":"b5-1120750","series-title":"AJNR Am J Neuroradiol","first-page":"1183","article-title":"The accuracy of CT and MR evaluation of the sella turcica for detection of ACTH-secreting adenomas in Cushing's disease","volume":"14","author":"Buchfelder","year":"1993"},{"key":"b6-1120750","series-title":"Eur J Endocrinol","first-page":"753","article-title":"Subclinical adenomas in postmortem pituitaries: classification and correlations to clinical data","volume":"154","author":"Buurman","year":"2006"},{"key":"b7-1120750","series-title":"Eur J Nucl Med","first-page":"11","article-title":"Labelling and metabolism of methionine-methyl-11C","volume":"1","author":"Comar","year":"1976"},{"key":"b8-1120750","series-title":"Radiology","first-page":"39","article-title":"Pituitary microadenomas: a PET study","volume":"177","author":"De Souza","year":"1990"},{"key":"b9-1120750","series-title":"J Clin Endocrinol Metab","first-page":"1553","article-title":"Accuracy of diagnostic tests for Cushing's syndrome: a systematic review and metaanalyses","volume":"93","author":"Elamin","year":"2008"},{"key":"b10-1120750","series-title":"Cancer","first-page":"613","article-title":"The prevalence of pituitary adenomas","volume":"101","author":"Ezzat","year":"2004"},{"key":"b11-1120750","series-title":"J Clin Endocrinol Metab","first-page":"3746","article-title":"Cushing's syndrome: important issues in diagnosis and management","volume":"91","author":"Findling","year":"2006"},{"key":"b12-1120750","series-title":"Neurol Res","first-page":"11","article-title":"Diagnostic value of super-selective bilateral cavernous sinus sampling with hypoythalamic stimulating hormone loading in patients with ACTH-producing adenoma","volume":"27","author":"Fujimura","year":"2005"},{"key":"b13-1120750","series-title":"J Clin Endocrinol Metab","first-page":"440","article-title":"Diagnosis and management of Cushing's syndrome: results of an Italian multicenter study. 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