Incidental Focal 18F-FDG Uptake in the Pituitary Gland: Clinical Significance and Differential Diagnostic Criteria

Journal of Nuclear Medicine

Byung-Tae Kim¹  Joon Young Choi¹  Kyung-Han Lee¹  Seung Hyup Hyun¹  Yearn Seong Choe¹ 

[1] Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

关键词: pituitary gland;    focal uptake;    incidentaloma;    ¹⁸F-FDG;    PET/CT;   

DOI  :  10.2967/jnumed.110.083733

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The purpose of this study was to identify the incidence and clinical significance of incidental pituitary uptake on whole-body 18F-FDG PET/CT. Methods: We evaluated 13,145 consecutive subjects who underwent 18F-FDG PET/CT. The final diagnosis of pathologic or physiologic uptake was based on brain MRI and follow-up PET scanning. Receiver-operating-characteristic curve analysis was performed to determine an optimal cutoff for detecting pathologic uptake. Results: We found that 107 (0.8%) subjects showed incidental pituitary uptake. In 29 of 71 subjects with the final diagnosis, the pituitary uptake was pathologic: macroadenomas (n = 21), microadenomas (n = 5), and malignancy (n = 3). When a maximum standardized uptake value of 4.1 was used as an optimal criterion for detecting pathologic uptake, the diagnostic sensitivity, specificity, and accuracy were 96.6%, 88.1%, and 91.5%, respectively. Conclusion: Although incidental pituitary uptake is an unusual finding, the degree of 18F-FDG accumulation is helpful in identifying pathologic pituitary lesions that warrant further diagnostic evaluation.

【 授权许可】

Unknown