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: Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра. , Этот адрес электронной почты защищен от спам-ботов. У вас должен быть включен JavaScript для просмотра.
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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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.