Jain Anjali, Usmani Sharjeel, Al Riyami Khulood, Mittal Avni, Abubakar Sofiullah, Al Busaidi Asiya, Kheruka Subhash Chand, Al Sukaiti Rashid
Department of Radiology & Nuclear Medicine, Sultan Qaboos Comprehensive Cancer Care, and Research Center, Muscat, Oman.
World J Nucl Med. 2024 May 1;23(3):161-167. doi: 10.1055/s-0044-1786733. eCollection 2024 Sep.
Recently developed digital positron emission tomography/computed tomography (PET/CT) scanners (digital PET [dPET]) have given new dimensions to molecular imaging. dPET scanner has very high sensitivity, spatial resolution, and image contrast that leads to increased uptake of signal in small-volume structures like pituitary gland (PG) making them visible on PET/CT scan even in absence of any pathology. Adequate knowledge of physiological fluoro-2 deoxy D glucose uptake in PG is required in interpretation of dPET for correct diagnosis and reducing unnecessary additional imaging. The aim of this study is to evaluate the frequency of physiological PG uptake on dPET. Eighty-eight subjects (mean age, 54.44 ± 14.18 years; range, 26-84 years; 63 females and 25 males) with normal PG on magnetic resonance imaging brain and imaged within 6 months on dPET were included in this research study. Out of 88 patients, 20 control subjects (mean age, 58.15 ± 11.08 years: 15 females and 5 males) underwent PET/CT on conventional PET. All images were acquired with similar and standard acquisition protocol and reconstruction done with Time of flight with Point spread function. PG uptake was compared visually and quantitatively. PG uptake was seen in 43 patients (48.8%). Out of 43 patients, 31 (72%) showed low uptake, 11 (26%) showed intermediate grade of uptake, and 1 patient (2%) showed intermediate-to-high uptake and was categorized as high-grade uptake. In the control group of 20 patients, 3 (15%) showed low uptake, while none of them showed intermediate or high uptake. Physiological PG uptake is commonly seen on dPET. Low-to-intermediate grade of PG uptake on dPET in an asymptomatic patient is physiological and does not require further evaluation and should be reported with caution.
最近开发的数字正电子发射断层扫描/计算机断层扫描（PET/CT）扫描仪（数字PET [dPET]）为分子成像带来了新的维度。dPET扫描仪具有非常高的灵敏度、空间分辨率和图像对比度，这使得垂体等小体积结构中的信号摄取增加，即使在没有任何病变的情况下，它们在PET/CT扫描中也可见。在解读dPET以进行正确诊断和减少不必要的额外成像时，需要充分了解垂体中生理性氟代脱氧葡萄糖摄取情况。本研究的目的是评估dPET上生理性垂体摄取的频率。
本研究纳入了88名受试者（平均年龄54.44±14.18岁；范围26 - 84岁；63名女性和25名男性），其脑部磁共振成像显示垂体正常，且在6个月内进行了dPET成像。在88名患者中，20名对照受试者（平均年龄58.15±11.08岁：15名女性和5名男性）接受了传统PET的PET/CT检查。所有图像均采用相似的标准采集协议进行采集，并采用飞行时间与点扩散函数进行重建。对垂体摄取情况进行了视觉和定量比较。
43名患者（48.8%）出现垂体摄取。在43名患者中，31名（72%）显示摄取较低，11名（26%）显示中等程度摄取，1名患者（2%）显示中等至高摄取并被归类为高等级摄取。在20名患者的对照组中，3名（15%）显示摄取较低，而他们中没有人显示中等或高摄取。
生理性垂体摄取在dPET上很常见。无症状患者dPET上低至中等程度的垂体摄取是生理性的，不需要进一步评估，报告时应谨慎。
