Radiopharmaceuticals for single photon emission computer tomography of pituitary adenomas


  • Sergiy Makeyev Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Stanislav Koval Romodanov Neurosurgery Institute, Kiev, Ukraine
  • Nikolay Guk Romodanov Neurosurgery Institute, Kiev, Ukraine



pituitary adenomas, diagnostics, single photon emission computer tomography, radiopharmaceuticals, Technetium-99m, technetium-99m methoxyisobutylisonitrile, indium-111-DTPA-D-Phe-1-octreotide, 99Tcm-HYNIC-TOC, iodine-123-Tyr-3-octreotide, Technetium-99m p


The literature review is dedicated to diagnostic capabilities of modern radiopharmaceuticals, used in single photon emission computer tomography of pituitary adenomas. Relevant statistic data and short historical overview of scintigraphy use in pituitary adenomas treatment are given. Research data on mechanisms of different radiopharmaceuticals, clinical prospects of application and diagnostic accuracy at single photon emission computer tomography of pituitary adenoma are analyzed and presented. Advantages of scintigraphy in comparison to routine instrumental diagnostics and additional capabilities in differential diagnosis of pituitary adenomas are described.

Author Biographies

Sergiy Makeyev, Romodanov Neurosurgery Institute, Kiev

Nuclear Medicine Department

Stanislav Koval, Romodanov Neurosurgery Institute, Kiev

Nuclear Medicine Department

Nikolay Guk, Romodanov Neurosurgery Institute, Kiev

Department of Transsphenoidal Neurosurgery


1. Pituitary Adenomas — Clinico-Pathological, Immunohistochemical and Ultrastructural Study. [Internet]. Intech; 2012. [cited 2012 February 10]. Available at:

2. Shakhvorost NP, Zhestikova MG, Michkayeva VI, Dantsiger DG, Aykina TP, Bryzgalina SM. Epidemiologiya bol'nykh s adenomami gipofiza po dannym lechebnykh uchrezhdeniy promyshlennogo goroda. [Epidemiology of patients with pituitary adenomas, according to medical institutions of the industrial city]. Byulleten'. Cib. meditsiny. Тematicheskiy vypusk 2009;1(2): 95–100. Russian.

3. Nikiforov BM, Matsko DE. Opukholi golovnogo mozga.[Brain tumors] St. Petersburg:Piter;2003. Russian.

4. Buchfelder M, Schlaffer SM. Modern imaging of pituitary adenomas. Front Horm Res. 2010;38:109-20. [CrossRef]

5. Chaudhary V, Bano S. Imaging of the pituitary: Recent advances. Indian Journal of Endocrinology and Metabolism. 2011;15(7):216. [CrossRef]

6. Makyeyev SS. Emisiyna tomohrafiya pukhlyn holovnoho mozku. [Emission tomography brain tumors]. Klyn. Onkolohy. 2011;3(3):92–95. Ukrainian.

7. Valotassiou V, Leondi A, Angelidis G, Psimadas D, Georgoulias P. SPECT and PET Imaging of Meningiomas. The Scientific World Journal. 2012;2012:1-11. [CrossRef]

8. Mirgorodskiy OA. Radioizotopnaya diagnostika vnutricherepnykh opukholey bazal'noy lokalizatsii: [dissertation]. Kiev (Ukraine); 1977. Russian.

9. Makeyev SS. Odnofotonna emisiyna kompyuterna tomohrafiya u diahnostytsi pukhlyn holovnoho mozku. [dissertation]. Kiev (Ukraine): Natsionalnyy instytut raku; 2008. Ukrainian.

10. O'Tuama LA, Packard AB, Treves ST. SPECT imaging of pediatric brain tumor with hexakis (methoxyisobutylisonitrile) technetium (I). J Nucl Med. 1990 Dec;31(12):2040-1. [PubMed]

11. Beller G, Watson D. Physiological basis of myocardial perfusion imaging with the technetium 99m agents. Seminars in Nuclear Medicine. 1991;21(3):173-181. [CrossRef]

12. Kojima T, Mizumura S, Kumita S, Kumazaki T, Teramoto A. Is technetium-99m-MIBI taken up by the normal pituitary gland? A comparison of normal pituitary glands and pituitary adenomas. Ann Nucl Med. 2001;15(4):321-327. [CrossRef]

13. Gierach M, Pufal J, Pilecki S, Junik R. The case of Cushing’s disease imaging by SPECT examination without manifestation of pituitary adenoma in MRI examination. Nucl Med Rev Cent East Eur. 2005;8(2):137-9. [PubMed]

14. Rao VV, Chiu ML, Kronauge JF, Piwnica-Worms D. Expression of recombinant human multidrug resistance P-glycoprotein in insect cells confers decreased accumulation of technetium-99m-sestamibi. J Nucl Med. 1994 Mar;35(3):510-5. [PubMed]

15. Piwnica-Worms D, Rao V, Kronauge J, Croop J. Characterization of Multidrug Resistance P-Glycoprotein Transport Function with an Organotechnetium Cation. Biochemistry. 1995;34(38):12210-12220. [CrossRef]

16. SHIBATA Y, MATSUMURA A, NOSE T. Effect of Expression of P-glycoprotein on Technetium-99m Methoxyisobutylisonitrile Single Photon Emission Computed Tomography of Brain Tumors. Neurologia medico-chirurgica. 2002;42(8):325-331. [CrossRef]

17. Reubi J, Laissue J, Krenning E, Lamberts S. Somatostatin receptors in human cancer: Incidence, characteristics, functional correlates and clinical implications. The Journal of Steroid Biochemistry and Molecular Biology. 1992;43(1-3):27-35. [CrossRef]

18. Theodoropoulou M, Stalla G. Somatostatin receptors: From signaling to clinical practice.Frontiers in Neuroendocrinology. 2013;34(3):228-252. [CrossRef]

19. Krenning EP, Bakker WH, Kooij PP, Breeman WA, Oei HY, de Jong M, Reubi JC, Visser TJ, Bruns C, Kwekkeboom DJ, et al. Somatostatin receptor scintigraphy with indium-111-DTPA-D-Phe-1-octreotide in man: Metabolism, dosimetry and comparison with iodine-123-Tyr-3-octreotide. J Nucl Med. 1992 May;33(5):652-658. [PubMed]

20. van Royen EA, Verhoeff NP, Meylaerts SA, Miedema AR. Indium-111-DTPA-octreotide uptake measured in normal and abnormal pituitary glands. J Nucl Med. 1996 Sep;37(9):1449-51. [PubMed]

21. Schmidt M, Scheidhauer K, Luyken C et al. Somatostatin receptor imaging in intracranial tumours. European Journal of Nuclear Medicine and Molecular Imaging. 1998;25(7):675-686. [CrossRef]

22. Lake MG1, Krook LS, Cruz SV. Pituitary adenomas: an overview. Am Fam Physician. 2013 Sep 1;88(5):319-327. [PubMed]

23. Tumiati MN, Facchi E, Gatti C, Bossi A, Longari V. Scintigraphic assessment of pituitary adenomas and several diseases by indium-111-pentetreotide. Q J Nucl Med. 1995 Dec;39(4 Suppl 1):98-100. [PubMed]

24. Boni G, Ferdeghini M, Bellina CR, Matteucci F, Castro Lopez E, Parenti G, Canapicchi R, Bianchi R. 111In-DTPA-D-Phe-octreotide scintigraphy in functioning and non-functioning pituitary adenomas. Q J Nucl Med. 1995 Dec;39(4 Suppl 1):90-93. [PubMed]

25. Losa M, Magnani P, Mortini P et al. Indium-111 pentetreotide single-photon emission tomography in patients with TSH-secreting pituitary adenomas: Correlation with the effect of a single administration of octreotide on serum TSH levels. Eur J Nucl Med. 1997;24(7):728-731. [CrossRef]

26. Pituitary Adenoma Imaging. [Internet]. Medscape; Available at:

27. Fard Esfehani A, Chavoshi M, Noorani M et al. Successful application of technetium-99m-labeled octreotide acetate scintigraphy in the detection of ectopic adrenocorticotropin-producing bronchial carcinoid lung tumor: a case report. J Med Case Rep. 2010;4(1):323. [CrossRef]

28. Veit J, Boehm B, Luster M et al. Detection of paranasal ectopic adrenocorticotropic hormone-secreting pituitary adenoma by Ga-68-DOTANOC positron-emission tomography-computed tomography. The Laryngoscope. 2013;123(5):1132-1135. [CrossRef]

29. Hofman M, Kong G, Neels O, Eu P, Hong E, Hicks R. High management impact of Ga-68 DOTATATE (GaTate) PET/CT for imaging neuroendocrine and other somatostatin expressing tumours. Journal of Medical Imaging and Radiation Oncology. 2012;56(1):40-47. [CrossRef]

30. LAURIERO F, PIERANGELI E, RUBINI G, RESTA M, DʼADDABBO A. Pituitary adenomas. Nuclear Medicine Communications. 1998;19(12):1127-1134. [CrossRef]

31. Luyken C, Hildebrandt G, Krisch B, Scheidhauer K, Klug N. Clinical relevance of somatostatin receptor scintigraphy in patients with skull base tumours. Acta Neurochir Suppl. 1996;65:102-4. [PubMed]

32. Kwekkeboom D, Krenning EP, de Jong M. Peptide receptor imaging and therapy. J Nucl Med. 2000 Oct;41(10):1704-1713. [PubMed]

33. Li F1, Chen LB, Jing HL, Du YR, Chen F. Preliminary clinical application of 99Tcm-HYNIC-TOC imaging in somatostatin receptor-positive tumors. Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2003 Oct;25(5):563-566. [PubMed]

34. Plachcinska A, Mikolajczak R, Maecke H et al. Clinical Usefulness of 99m Tc-EDDA/HYNIC-TOC Scintigraphy in Oncological Diagnostics: A Pilot Study. Cancer Biotherapy & Radiopharmaceuticals. 2004;19(2):261-270. [CrossRef]

35. Artiko V, Sobic-Saranovic D, Pavlovic S, Petrovic M, Zuvela M, Antic A, Matic S, Odalovic S, Petrovic N, Milovanovic A, Obradovic V. The clinical value of scintigraphy of neuroendocrine tumors using (99m)Tc-HYNIC-TOC. J BUON. 2012 Jul-Sep;17(3):537-542. [PubMed]

36. Ramírez C, Hernández-Ramirez L, Espinosa-de-los-Monteros A, Franco J, Guinto G, Mercado M. Ectopic acromegaly due to a GH-secreting pituitary adenoma in the sphenoid sinus: a case report and review of the literature. BMC Research Notes. 2013;6(1):411. [CrossRef]

37. Kaushik C, Ramakrishnaiah R, Angtuaco EJ. Ectopic pituitary adenoma in persistent craniopharyngeal canal: Case report and literature review. J Comput Assist Tomogr. 2010 Jul;34(4):612-4. [CrossRef]

38. Kusano Y, Horiuchi T, Oya F et al. Ectopic Pituitary Adenoma Associated with an Empty Sella: A Case Report and Review of the Literature. Journal of Neuroimaging. 2011;23(1):135-136. [CrossRef]

39. Mudd PA, Hohensee S, Lillehei KO, Kingdom TT, Kleinschmidt-Demasters BK. Ectopic pituitary adenoma of the clivus presenting with apoplexy: Case report and review of the literature. Clin Neuropathol. 2012 Jan-Feb;31(1):24-30. [PubMed]

40. Newey P, Thakker R. Role of Multiple Endocrine Neoplasia Type 1 Mutational Analysis in Clinical Practice. Endocrine Practice. 2011;17(Supplement 3):8-17. [CrossRef]

41. Marini F, Falchetti A,Luzi E, Tonelli F, Brandi ML. Multiple Endocrine Neoplasia Type 1 (MEN1) Syndrome. [Internet]. Cancer Syndromes; 2008. Available at:

42. Tamagno G1, De Carlo E, Martini C, Rubello D, Fallo F, Sicolo N. The early diagnosis of multiple endocrine neoplasia type 1 (MEN 1): a case report. J Endocrinol Invest. 2004 Oct;27(9):878-882. [PubMed]

43. Naswa N, Das C, Sharma P, Karunanithi S, Bal C, Kumar R. Ectopic pituitary adenoma with empty sella in the setting of MEN-1 syndrome: detection with 68Ga-DOTANOC PET/CT. Jpn J Radiol. 2012;30(9):783-786. [CrossRef]

44. Yokoyama A, Saji H. Tumor diagnosis using radioactive metal ions and their complexes. Metal Ions in Biological Systems. 1980;10:313–340.

45. Palmedo H, Hensel J, Bender H. F-18 FDG, Tc-99m (v)DMSA and Tc-99m MIBI in an animal beast cancer-model: Comparison of tumor-uptake and correlation with scintigraphic and PET-detection. Eur. J. Nucl. Med. 2000;27:1130.

46. Palmedo H, Schomburg A, Grünwald F, Mallmann P, Krebs D, Biersack HJ. Technechium-99m-MIBI scintimammography for suspicious breast lesions. J Nucl Med. 1996 Apr;37(4):626-30. [PubMed]

47. Denoyer D, Perek N, Le Jeune N, Frere D, Dubois F. Evidence that 99mTc-(V)-DMSA uptake is mediated by NaPi cotransporter type III in tumour cell lines. European Journal of Nuclear Medicine and Molecular Imaging. 2003;31(1):77-84. [CrossRef]

48. Horiuchi K, Saji H, Yokoyama A. Tc(V)-DMS tumor localization mechanism: a pH-sensitive Tc(V)-DMS—enhanced target/nontarget ratio by glucose-mediated acidosis. Nuclear Medicine and Biology. 1998;25(6):549-555. [CrossRef]

49. Colao A, Ferone D, Lombardi G, Lastoria S. 99mTechnetium pentavalent dimercaptosuccinic acid scintigraphy in the follow-up of clinically nonfunctioning pituitary adenomas after radiotherapy. Clin Endocrinol. 2002;56(6):713-721. [CrossRef]

50. Denoyer D, Perek N, Le Jeune N, Cornillon J, Dubois F. Correlation between 99mTc-(V)-DMSA uptake and constitutive level of phosphorylated focal adhesion kinase in an in vitro model of cancer cell lines.European Journal of Nuclear Medicine and Molecular Imaging. 2005;32(7):820-827. [CrossRef]

51. YAMAMURA K, SUZUKI S, YAMAMOTO I. Differentiation of Pituitary Adenomas From Other Sellar and Parasellar Tumors by 99mTc(V)-DMSA Scintigraphy. Neurologia medico-chirurgica. 2003;43(4):181-187. [CrossRef]

52. Makeyev CC, Mechev DS, Rozumenko VD. Odnofotonna emisiyna komp`yuterna tomohrafiya u diahnostytsi pukhlyn holovnoho mozku. [Single photon emission computer tomography in the diagnosis of brain tumors]. Kiev:Interservis; 2012.Ukrainian.



How to Cite

Makeyev, S., Koval, S., & Guk, N. (2014). Radiopharmaceuticals for single photon emission computer tomography of pituitary adenomas. Ukrainian Neurosurgical Journal, (2), 20–24.



Review articles