European journal of nuclear medicine and molecular imaging · 2025
A novel molecular imaging technique using [68Ga]Ga-mDesmo PET-CT for localizing tumors in Cushing's disease.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Walia Rama, Chakraborty Ananda Mohan, Pandey Somit, Rana Nivedita, Kumar Rajender, Ahuja Chirag, Singh Harmandeep, Dhandapani Sivashanmugam, Sahoo Sushant Kumar, Chhabra Rajesh, Singh Apinderpreet, Bhadada Sanjay Kumar, Mittal B R, Chatterjee Debajyoti, Grossman Ashley, Shukla Jaya
Аннотация
INTRODUCTION: Localizing the source of adrenocorticotropic hormone (ACTH) in patients with ACTH-dependent Cushing's syndrome (CS) poses significant challenges. There is a pressing need for novel imaging modalities that provide both anatomical delineation and functional confirmation of corticotropinomas.
METHODS: This study utilized a modified form of desmopressin (mDesmo), an agonist of the V1b receptor, which is overexpressed in tumoral corticotrophs. After modification, radionuclide 68Ga was chelated to produce a new radiopharmaceutical for positron emission tomography (PET) imaging. A total of 234 patients with CS were screened and 30 underwent [68Ga]Ga-mDesmo imaging. Patient demographics and hormonal levels (plasma cortisol and ACTH) were recorded, and the diagnostic accuracy of contrast-enhanced MRI (CE-MRI) and [68Ga]Ga-mDesmo was compared, with histopathological evidence of a corticotropinoma serving as the reference standard.
RESULTS: The cohort comprised 10 males (33%, CI: 16-50%) and 20 females (67%, CI: 50-84), with a mean age of 33.5 ± 13.5 years. Of 30 patients with CS, 24 patients had treatment naïve Cushing's disease (CD) of which 17 (71%, CI: 53-89%) had microadenomas and 7 (30%, CI: 12-48%) had macroadenoma; 4 (13%, CI: 0-25%) patients had ectopic Cushing syndrome (ECS). CE-MRI identified lesions in 16 patients (67%, CI: 48-86%), while [68Ga]Ga-mDesmo successfully identified corticotropinomas in all 24 patients (100%, CI: 86-100%). In patients with microadenomas, CE-MRI had a diagnostic accuracy of 53% (CI: 29-77%), whereas [68Ga]Ga-mDesmo achieved 100% (CI: 86-100%). There was no uptake of [68Ga]Ga-mDesmo in the pituitary of patients with ECS.
CONCLUSION: This study demonstrates that [68Ga]Ga-mDesmo imaging is an effective in vivo molecular imaging technique for delineating corticotropinomas, surpassing the accuracy of CE-MRI and BIPSS, regardless of adenoma size.
TRIAL REGISTRATION NUMBER: CTRI/2022/08/044615 dated 03/08/2022.
METHODS: This study utilized a modified form of desmopressin (mDesmo), an agonist of the V1b receptor, which is overexpressed in tumoral corticotrophs. After modification, radionuclide 68Ga was chelated to produce a new radiopharmaceutical for positron emission tomography (PET) imaging. A total of 234 patients with CS were screened and 30 underwent [68Ga]Ga-mDesmo imaging. Patient demographics and hormonal levels (plasma cortisol and ACTH) were recorded, and the diagnostic accuracy of contrast-enhanced MRI (CE-MRI) and [68Ga]Ga-mDesmo was compared, with histopathological evidence of a corticotropinoma serving as the reference standard.
RESULTS: The cohort comprised 10 males (33%, CI: 16-50%) and 20 females (67%, CI: 50-84), with a mean age of 33.5 ± 13.5 years. Of 30 patients with CS, 24 patients had treatment naïve Cushing's disease (CD) of which 17 (71%, CI: 53-89%) had microadenomas and 7 (30%, CI: 12-48%) had macroadenoma; 4 (13%, CI: 0-25%) patients had ectopic Cushing syndrome (ECS). CE-MRI identified lesions in 16 patients (67%, CI: 48-86%), while [68Ga]Ga-mDesmo successfully identified corticotropinomas in all 24 patients (100%, CI: 86-100%). In patients with microadenomas, CE-MRI had a diagnostic accuracy of 53% (CI: 29-77%), whereas [68Ga]Ga-mDesmo achieved 100% (CI: 86-100%). There was no uptake of [68Ga]Ga-mDesmo in the pituitary of patients with ECS.
CONCLUSION: This study demonstrates that [68Ga]Ga-mDesmo imaging is an effective in vivo molecular imaging technique for delineating corticotropinomas, surpassing the accuracy of CE-MRI and BIPSS, regardless of adenoma size.
TRIAL REGISTRATION NUMBER: CTRI/2022/08/044615 dated 03/08/2022.