000			04625nam a22006497a 4500
008			190724s20192019 xxu||||| |||| 00| 0 eng d
022			_a1355-008X
024			_a10.1007/s12020-019-01944-7 [doi]
024			_a10.1007/s12020-019-01944-7 [pii]
040			_aOvid MEDLINE(R)
099			_a31062234
245			_aCRH stimulation improves 18F-FDG-PET detection of pituitary adenomas in Cushing's disease.
251			_aEndocrine. 65(1):155-165, 2019 07.
252			_aEndocrine. 65(1):155-165, 2019 07.
252			_zEndocrine. 65(1):155-165, 2019 Jul.
253			_aEndocrine
260			_c2019
260			_fFY2020
265			_sppublish
266			_d2019-05-21
268			_aEndocrine. 65(1):155-165, 2019 Jul.
520			_aCLINICAL TRIAL INFORMATION: <sup>18</sup>F-FDG-PET imaging with and without CRH stimulation was performed under the clinical trial NIH ID 12-N-0007 (clinicaltrials.gov identifier NCT01459237). The transsphenoidal surgeries and post-operative care was performed under the clinical trial NIH ID 03-N-0164 (clinicaltrials.gov identifier NCT00060541).
520			_aCONCLUSIONS: The results of the current study suggest that oCRH-stimulation may lead to increased <sup>18</sup>F-FDG uptake, and increased rate of detection of corticotropinomas in CD. These results also suggest that some MRI invisible adenomas may be detectable by oCRH-stimulated FDG-PET imaging.
520			_aMETHODS: Subjects with a likely diagnosis of CD (n = 27, 20 females) each underwent two <sup>18</sup>F-FDG-PET studies [without and with ovine-CRH (oCRH) stimulation] on a high-resolution PET platform. Standardized-uptake-values (SUV) in the sella were calculated. Two blinded neuroradiologists independently read <sup>18</sup>F-FDG-PET images qualitatively. Adenomas were histopathologically confirmed, analyzed for mutations in the USP8 gene and for glycolytic pathway proteins.
520			_aOBJECTIVE: In MRI-negative cases Cushing's disease (CD), surgeons perform a more extensive exploration of the pituitary gland, with fewer instances of hormonal remission. <sup>18</sup>F-fluoro-deoxy-glucose (<sup>18</sup>F-FDG) positron emission tomography (PET) has a limited role in detecting adenomas that cause CD (corticotropinomas). Our previous work demonstrated corticotropin-releasing hormone (CRH) stimulation leads to delayed, selective glucose uptake in corticotropinomas. Here, we prospectively evaluated the utility of CRH stimulation in improving <sup>18</sup>F-FDG-PET detection of adenomas in CD.
520			_aRESULTS: The mean-SUV of adenomas was significantly increased from baseline (3.6 +/- 1.5) with oCRH administration (3.9 +/- 1.7; one-tailed p = 0.003). Neuroradiologists agreed that adenomas were visible on 21 scans, not visible on 26 scans (disagreed about 7, kappa = 0.7). oCRH-stimulation led to the detection of additional adenomas (n = 6) not visible on baseline-PET study. Of the MRI-negative adenomas (n = 5), two were detected on PET imaging (one only after oCRH-stimulation). USP8 mutations or glycolytic pathway proteins were not associated with SUV in corticotropinomas.
546			_aEnglish
650			_a*ACTH-Secreting Pituitary Adenoma/di [Diagnosis]
650			_a*Adenoma/di [Diagnosis]
650			_a*Corticotropin-Releasing Hormone/me [Metabolism]
650			_a*Fluorodeoxyglucose F18
650			_a*Pituitary ACTH Hypersecretion/di [Diagnosis]
650			_a*Positron-Emission Tomography/mt [Methods]
650			_aACTH-Secreting Pituitary Adenoma/me [Metabolism]
650			_aACTH-Secreting Pituitary Adenoma/pa [Pathology]
650			_aAdenoma/me [Metabolism]
650			_aAdenoma/pa [Pathology]
650			_aAdolescent
650			_aAdult
650			_aChild
650			_aDiagnosis, Differential
650			_aFemale
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aPituitary ACTH Hypersecretion/me [Metabolism]
650			_aPituitary ACTH Hypersecretion/pa [Pathology]
650			_aSensitivity and Specificity
650			_aYoung Adult
651			_aMedStar Washington Hospital Center
656			_aMedicine/Endocrinology
657			_aJournal Article
700			_aSharma, Susmeeta
790			_aBenzo S, Boyle J, Chatain GP, Chittiboina P, Dieckman W, Edwards N, Hayes CP, Herscovitch P, Lodish MB, Lonser RR, Maric D, Millo C, Nieman LK, Patronas NJ, Ray Chaudhury A, Scott G, Sharma S, Smirniotopoulos J, Stratakis CA
856			_uhttps://dx.doi.org/10.1007/s12020-019-01944-7 _zhttps://dx.doi.org/10.1007/s12020-019-01944-7
942			_cART _dArticle
999			_c4202 _d4202