| In vivo assay of folate receptors in nonfunctional pituitary adenomas with 99mTc-folate SPECT/CT. | |
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MedLine Citation:
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PMID: 20956474 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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METHODS: Fifty-six patients (29 men, 27 women; age range, 29-82 y) with clinically nonfunctional pituitary adenomas on MRI underwent preoperative imaging using 666 MBq (18 mCi) of (99m)Tc-folate. SPECT/CT images and whole-body and lateral head planar images were acquired approximately 2 h after injection. Surgical resection took place within a week. WBA on a portion of the excised specimens assessed folate receptor expression in 49 patients. Attenuation-corrected (99m)Tc-folate SPECT/CT images were assessed qualitatively and quantitatively (maximal adenoma counts to background), with WBA as a standard. RESULTS: Integrated CT was useful for uptake localization and assisted region-of-interest placement. Qualitative interpretation of planar imaging yielded a sensitivity of 81% and specificity of 72%. Qualitative SPECT/CT yielded a sensitivity of 94% and specificity of 61%. Receiver-operating-characteristic curve analysis of quantitative uptake yielded a tumor-to-background cutoff ratio of 3.5, with a sensitivity of 81% and specificity of 83%. Scalp uptake yielded consistent results (over the brain, neck, and choroid plexus) for background when SPECT/CT misalignment artifacts were avoided. Detection of pituitary uptake on anterior-posterior and lateral images was hampered by facial uptake, which varied between patients. CONCLUSION: SPECT/CT of (99m)Tc-folate is an accurate method of assaying folate receptors in vivo and may provide a quantitative marker for identifying folate receptor-positive tumors. This method may also prove beneficial in selecting patients for folate-targeted therapy of clinically nonfunctional pituitary adenomas, for which there is currently no medical therapy. |
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Authors:
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James R Galt; Raghuveer K Halkar; Chheng-Orn Evans; Naema A Osman; David LaBorde; Timothy H Fox; Bajat A Faraj; Kush Kumar; Houping Wang; Nelson M Oyesiku |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-10-18 |
Journal Detail:
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Title: Journal of nuclear medicine : official publication, Society of Nuclear Medicine Volume: 51 ISSN: 1535-5667 ISO Abbreviation: J. Nucl. Med. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-05 Completed Date: 2010-12-15 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0217410 Medline TA: J Nucl Med Country: United States |
Other Details:
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Languages: eng Pagination: 1716-23 Citation Subset: IM |
Affiliation:
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Department of Radiology, Emory University, Atlanta, Georgia 30322, USA. jgalt@emory.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Aged, 80 and over Female Folate Receptors, GPI-Anchored / metabolism* Folic Acid / drug effects* Humans Male Middle Aged Organotechnetium Compounds / diagnostic use* Pituitary Neoplasms / diagnosis*, metabolism*, radiography, radionuclide imaging ROC Curve Sensitivity and Specificity Tomography, Emission-Computed, Single-Photon* Tomography, X-Ray Computed* |
| Grant Support | |
ID/Acronym/Agency:
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NS051439-03/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Folate Receptors, GPI-Anchored; 0/Organotechnetium Compounds; 59-30-3/Folic Acid |
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