JOURNAL DESCRIPTION
The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.
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Medical Radiology and Radiation Safety. 2025. Vol. 70. № 3
DOI:10.33266/1024-6177-2025-70-2-99-107
W.Yu. Ussov1, S.M. Minin1, Zh.Zh. Anashbayev1, S.I. Sazonova2,
O.I. Belichenko3, E.A. Golovina4, Yu.B. Lishmanov2, A.M. Cherniavsky1
Quantitative Brain SPECT/CT with 99mTc-Technetril
for Visualization and Assessment of the Functional State of Pituitary Adenomas
1 E.N. Meshalkin National Research Medical Center, Novosibirsk, Russia
2 Scientific Research Institute of Cardiology, Tomsk, Russia
3 Russian University of Sports GTSOLIFK, Moscow, Russia
4 National Research Tomsk Polytechnic University, Tomsk, Russia
Contact person: Ussov Wladimir Yuryevich, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. , This email address is being protected from spambots. You need JavaScript enabled to view it.
Summary
Purpose: We tried to adapt the methodology for quantifying the accumulation of 99mTc-technetril (99mTc-MIBI) in pituitary adenomas, present a pharmacokinetic model for calculating blood flow in the pituitary gland based on the accumulation of 99mTc-technetril and evaluate their relationship with the level of prolactin in the blood in some pathological conditions.
Material and methods: The tumor blood flow (TBF) was calculated using the standardized radiopharmaceutical absorption value (SUV) and the minute volume of the heart (MV) as TBF = SUV99mTc-technetril × (MV / BodyWeight) × 100, where 100 is the conversion coefficient for representing the result in generally accepted units of ml/min/100 cm3 of tissue. The value of
SUV99mTc-technetril can be determined using modern digital tomographic gamma cameras automatically, using source calibration with graduated specific radioactivity, or using phantoms with known radioactivity, with the construction of a regression relationship local kBq activity/ml – scintillation count per voxel and determining the true accumulation of radiopharmacutical in the tissue tumors, in kBq/cm3 units of tissue.
SPECT/CT of the brain with 99mTc-technetril (185–240 MBq, Gemini 700 gamma cameras and GE Discovery NM/CT 670 Pro) was performed in 8 patients without pituitary pathology (4 men and women, 34–63 years old) – control group, 9 patients with pituitary microadenomas (5 women and 4 men, 32–51 years old), and 8 patients (5 women and 3 men, 32–56 years old) with pituitary macroadenomas. All patients in groups 2 and 3 had an increase in blood prolactin levels > 35 mg/l, and all of them then received therapy with bromocriptine 2.5 mg/day or higher.
Results: Visually, SPECT/CT showed nodular inclusion in pituitary micro- and macroadenomas. SUV significantly differed between the groups and amounted to 1.23 ± 0.25 (0.85–1.39) in the control group, respectively, with microadenomas 7,20 ± 1,17 (4,5–12,9) (p < 0.02 compared with the control), and with macroadenomas 12.54 ± 3.62 (3.9–4.85) (p < 0.005). The tissue blood flow was, respectively 9,2 ± 2,0 (6,9–14,2): 36,9 ± 7,3 (26,3–72,3) (p < 0.01): and 68.3 ±14.9 (21.0–78.2)(p < 0.002. SUV99mTc-technetril > 5.8 for pituitary nodule was found to be correlated with blood prolactin levels of over 200 mg/l (p = 0.045). A decrease in the SUV99mTc-technetril of the pituitary gland < 3.9 during therapy with bromocriptine 2.5 mg/day was combined with a decrease in blood prolactin levels below 150 mg/l (p = 0.0482).
Conclusion: SPECT/CT of the brain with 99mTc-technetril is an informative additional method of examining patients with pathology of the hypothalamic-pituitary system and allows determining the standardized amount of radiopharmaceutical absorption, as well as pituitary blood flow. It is advisable to use SPECT/CT of the brain with 99mTc-technetril for prospective monitoring of therapy of pituitary pathology, as an adjunct to MRI. A further study of the role of pituitary SPECT/CT with 99mTc-technetril in a wider population of endocrinological patients is needed for inclusion in the standard algorithm and clinical recommendations for patient examination.
Keywords: SPECT/CT, 99mTc-MIBI, pituitary adenomas, dynamic SPECT, dynamic scintigraphy, pituitary blood flow
For citation: Ussov WYu, Minin SM, Anashbayev ZhZh, Sazonova SI, Belichenko OI, Golovina EA, Lishmanov YuB, Cherniavsky AM. Quantitative Brain SPECT/CT with 99mTc-technetril for Visualization and Assessment of the Functional State of Pituitary Adenomas. Medical Radiology and Radiation Safety. 2025;70(3):99–107. (In Russian). DOI:10.33266/1024-6177-2025-70-3-99-107
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PDF (RUS) Full-text article (in Russian)
Conflict of interest. The authors declare no conflict of interest.
Financing. The study had no sponsorship.
Contribution. Article was prepared with equal participation of the authors.
Article received: 20.02.2025. Accepted for publication: 25.03.2025.