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Related Concept Videos

The Pituitary Gland01:17

The Pituitary Gland

The pituitary is a small endocrine organ in the sphenoid bone under the hypothalamus. Primarily, the pituitary in adults has two distinct anatomical and functional regions— the anterior and posterior lobes. During human fetal development, a third pituitary gland region called the pars intermedia atrophies and disappears. However, some of its cells migrate and exist adjacent to the anterior pituitary in adults.
Imaging Studies II: Positron Emission Tomography and Scintigraphy01:25

Imaging Studies II: Positron Emission Tomography and Scintigraphy

Positron Emission Tomography (PET) is a medical imaging technique that provides crucial insights into the body's physiological functions at a molecular level. It is an indispensable resource for diagnosing, staging, and monitoring various illnesses, notably cancer, neurological disorders, and cardiovascular conditions.
Fundamental Principles of PET
Imaging Studies IV: Magnetic Resonance Imaging01:27

Imaging Studies IV: Magnetic Resonance Imaging

Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
Positron Emission Tomography01:29

Positron Emission Tomography

Positron emission tomography (PET) is a medical imaging technique involving radiopharmaceuticals — substances that emit short-lived radiation. Although the first PET scanner was introduced in 1961, it took 15 more years before radiopharmaceuticals were combined with the technique and revolutionized its potential.
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body being...

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Updated: Jun 18, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas

Published on: January 17, 2018

Functional pituitary adenoma imaging.

Linus Hesse1,2,3, Linus Haberbosch4,5,6

  • 1Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Department of Endocrinology and Metabolism, European Reference Network On Rare Endocrine Diseases (ENDO-ERN), 10117, Berlin, Germany.

Reviews in Endocrine & Metabolic Disorders
|June 17, 2026
PubMed
Summary
This summary is machine-generated.

This review outlines a tiered imaging strategy for pituitary neuroendocrine tumors (PitNETs), emphasizing PET scans when MRI is inconclusive. It guides tracer selection and integration with clinical data for improved diagnosis and treatment planning.

Keywords:
AcromegalyCushing’s diseasePituitary adenomaPituitary neuroendocrine tumourPositron emission tomographyProlactinoma

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Area of Science:

  • Endocrinology
  • Radiology
  • Nuclear Medicine

Background:

  • High-resolution pituitary MRI effectively localizes most pituitary neuroendocrine tumors (PitNETs).
  • However, challenges persist in identifying very small functioning tumors (e.g., corticotroph microadenomas) and distinguishing post-operative tumor remnants from scar tissue.
  • Functional imaging, particularly Positron Emission Tomography (PET), has emerged as a valuable tool for equivocal cases.

Purpose of the Study:

  • To propose an MRI-first, tiered imaging strategy for diagnosing and managing PitNETs.
  • To provide guidance on selecting appropriate PET tracers based on clinical context.
  • To optimize PET acquisition and interpretation within a physiology-led framework.

Main Methods:

  • Review of current imaging modalities for PitNETs.
  • Discussion of the role of functional imaging, specifically PET, in challenging cases.
  • Proposal of a tiered imaging approach integrating MRI and PET.

Main Results:

  • PET imaging, when used selectively and interpreted physiologically, can resolve diagnostic ambiguities in PitNET management.
  • The review details the available PET tracers, including [11C]methionine, [68Ga]SSTR ligands, [68Ga]PentixaFor, [18F]FET, and [18F]FDG.
  • Integration of imaging findings with endocrine phenotype and treatment history is crucial.

Conclusions:

  • An MRI-first, tiered imaging strategy enhances the diagnostic accuracy for challenging PitNET cases.
  • Pragmatic tracer selection and optimized PET protocols are essential for maximizing clinical impact.
  • This approach aims to improve patient outcomes while preserving pituitary function.