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| ID | Type | Description | Link |
|---|---|---|---|
| 2017-002721-38 | EudraCT Number |
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Cushing's disease is characterized by the existence of a benign pituitary tumor developed from corticotropic cells responsible for excessive ACTH secretion. This results in hypercorticism causing high morbidity and mortality and severely impairing quality of life. The etiological diagnosis is based on Magnetic Resonance Imaging (MRI). However, pituitary MRI revealed a pituitary tumor in only 60% of patients. The diagnostic procedure is complicated by the existence of extra pituitary tumors responsible for ACTH ectopic secretion. This rare etiology imposes, in the absence of typical pituitary image, the realization of catheterization of the lower petrosal sinuses. Treatment of Cushing's disease is based on transsphenoidal surgical management, even in the absence of a formal MRI image, if pituitary origin is confirmed by the catheterization. Although pituitary surgery without identified target is part of French recommendations, this surgery is associated with a high risk of failure and morbidity. Optimization of the management of patients' with Cushing's disease thus requires the improvement of the diagnostic methods.
Hypothesis of our study is that [11C] MET MRI-PET may be performed as a first-line MRI for suspected Cushing's disease and may limit indications for catheterization of lower petrosal sinuses. Its localizing value should also make it possible to improve the surgical results with a better identification of the adenoma
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with Cushing's disease | Experimental | Implementation of [11C]-Methionine PET/MRI |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| [11C]-Methionine PET/MRI | Other | Implementation [11C]-Methionine PET/MRI performed for each patient in one place (department of nuclear medicine of the Hospices Civils de Lyon). The [11C]-Methionine PET/MRI will be performed after a pituitary MRI and before a transsphenoidal surgery. |
| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity of [11C]-Methionine PET/MRI | Sensitivity of [11C]-Methionine PET/MRI to correctly localizes the pituitary corticotropic adenoma in comparison with the sensitivity of the pituitary MRI. The gold standard being the localization defined by anatomopathological analysis on operative resection. | Within 3 months and 3 weeks after inclusion |
| Measure | Description | Time Frame |
|---|---|---|
| False negatives and false positives description | Description of false negatives and false positives [11C]-Methionine PET/MRI to identify and localize the microadenoma. Characteristics of unidentified adenomas will be described using: volume, localization, type of fixation | Within 3 months and 3 weeks after inclusion |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| BOURNAUD Claire, MD | Hospices Civils de Lyon | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service de Médecine Nucléaire - Hospices Civils de Lyon | Bron | 69677 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40841148 | Result | Flaus A, Levigoureux E, Haesebaert J, Briet C, Castinetti F, Cristante J, Drui D, Germain N, Maione L, Illouz F, Sonnet E, Tauveron I, Merida I, Lancelot S, Costes N, Vasiljevic A, Marchand L, Rode S, Bertholon-Gregoire M, Criton G, Lapras V, Cotton F, Jouanneau E, Bournaud C, Raverot G. Prospective Multicenter Evaluation of [11C]Methionine PET/MRI Sensitivity Compared with MRI for Localizing Small Pituitary Neuroendocrine Tumor or Pituitary Adenoma in Cushing Disease. J Nucl Med. 2025 Oct 1;66(10):1575-1580. doi: 10.2967/jnumed.124.269392. | |
| 41760695 |
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| ID | Term |
|---|---|
| D047748 | Pituitary ACTH Hypersecretion |
| D006967 | Hypersensitivity |
| ID | Term |
|---|---|
| D006964 | Hyperpituitarism |
| D010900 | Pituitary Diseases |
| D007027 | Hypothalamic Diseases |
| D001927 | Brain Diseases |
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| Description of identified microadenomas |
Proportion of microadenomas identified by the [11C]-Methionine PET/MRI as a function of the degree of aggressiveness of the adenoma, evaluated by the number of mitoses, the level of expression of Ki67 and p53. |
| Within 3 months and 3 weeks months after inclusion |
| Comparison of [11C]-Methionine PET/MRI and pituitary MRI | Study of the concordance between the results of [11C]-Methionine PET/MRI and pituitary MRI | Within 3 months and 3 weeks months after inclusion |
| Derived |
| Flaus A, Pattee A, Criton G, Costes N, Levigoureux E, Haesebaert J, Vasiljevic A; IMPEC Collaborators; Jouanneau E, Cotton F, Bournaud C, Raverot G. [(1)(1)C]Methionine PET uptake kinetics in corticotroph pituitary neuroendocrine tumors. Sci Rep. 2026 Feb 27;16(1):8854. doi: 10.1038/s41598-026-39219-7. |
| D002493 |
| Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D004700 | Endocrine System Diseases |
| D007154 | Immune System Diseases |