Abstract
We have performed pituitary scintigraphy with the somatostatin (SS) analog pentetreotidean by (111In-P) in patients with GH-secreting adenoma or with “clinically non functioning” adenoma (NFA) to evaluate the presence and the functionality of SS receptors (SS-R). 111In-P pituitary accumulation was expressed as Activity Ratio (AR): the ratio between the uptake of radioactivity by the adenoma and that of the normal brain tissue. In subjects without pituitary disease, AR ranged from 1.6 to 2.2 and a value lower than 2.2 was thus arbitrarily considered as normal. In 15 out of the 17 patients with GH-secreting adenoma, an accumulation of the radioligand was shown. Median AR was 3.8 (range 1–6.9; in 14 AR were greater that 2.2) and ARs were directly correlated (r=0.54; p<0.05) with the suppressibility of plasma GH levels by octreotide (OC) acute administration. In two patients who repeated scintigraphy during chronic OC treatment, AR values were reduced. In all the 22 patients with NFA an accumulation of 111In-P at the pituitary level was observed and median AR was 3.0 (range 1.5–20; in 14 greater that 2.2). In vitro autoradiography of surgical specimens in 6 NFA patients revealed SS-R in 4 cases with high scintigraphic AR and negative results in two cases with low AR. Scintiscan was repeated during chronic OC treatment in 5 patients with high score: AR decreased in one patient, increased in three, and did not change in the other patient. No changes in tumor size were shown in any of these patients. A total of 8 patients (3 GH secreting and 5 NFA) had “normal” AR values Conclusions: in acromegaly scintigraphy with 111In-P visualizes functioning pituitary SS-R coupled to intracellular events that control hormonal hypersecretion and tumor growth. In contrast, in spite of the positivity of 111ln-P imaging in most patients with NFA, their receptors might have a defect in the coupling-transduction process, as they are not inhibited by OC treatment and no tumor shrinkage is observed.
Similar content being viewed by others
References
Krenning E.P., Bakker W.H., Breeman W.A.P., Koper J.W., Kooji P.P.M., Ausema L., Lameris J.S., Lamberts S.W.J. Localization of endocrine related tumours with radioiodinated analogue of somatostatin. Lancet I: 242, 1989.
Lamberts S.WJ., Bakker W.H., Reubi J.C., Krenning E.P. Somatostatin receptor imaging in the localization of endocrine tumours. N. Engl. J. Med. 323: 1246, 1990.
Ikuyama S., Nawata H., Kato K., Ibayashi H., Nakagaki H. Specific somatostatin receptors on human pituitary adenoma cell membranes. J. Clin. Endocrinol. Metab. 61: 666, 1985.
Reubi J.C., Heitz P.U., Landolt A.M. Visualization of somatostatin receptors and correlation with immunoreactive growth hormone and prolactin in human pituitary adenomas: evidence for different tumor subclasses. J. Clin. Endocrinol. Metab. 65: 65, 1987.
Greenman Y., Melmed S. Expression of three somatostatin receptor subtypes in pituitary adenomas: evidence for preferential SSTR5 expression in the mammosomatotroph lineage. J. Clin. Endocrinol. Metab. 79: 724, 1994.
Lamberts S.W.J. Sandostatin in the treatment of acromegaly. Springer-Verlag, New York, 1988, p. 1.
Chiodini P.G., Cozzi R., Dallabonzana D., Oppizzi G., Verde G., Petroncini M., Liuzzi A., Boccardi E., Lancranjan I. Medical treatment of acromegaly — Dopaminergic agonists and long-acting somatostatin. In: Muller E.E., Cocchi D., Locatelli V., (Eds.), Advances in growth hormone and growth factor research. Pythagora Press; Roma-Milano Berlin-Heidelberg: Springer-Verlag; 1989, p. 423.
Mundler O., Duet M., Chanson P., Rohmer Y., Ajzenberg C., Warnet A. Preliminary results with somatostatin receptors imaging in pituitary adenoma. 3rd Int. Pituitary Congress, Marina del Rey, CA, USA, 1993, Abst MA-43.
Faglia G., Bazzoni N., Spada A., Arosio M., Ambrosi B., Spinelli F., Sara R., Bonino C., Lunghi F. In vivo detection of somatostatin receptors in patients with functionless pituitary adenomas by means of a radioiodinated analog of somatostatin (123-I SDZ 204–090). J. Clin. Endocrinol. Metab. 73: 850, 1991.
Ur E., Mather S.J., Bomanji J., Ellison D., Britton K.E., Grossman A.B., Wass J.A.H., Besser G.M. Pituitary imaging using a labelled somatostatin analogue in acromegaly. Clin. Endocrinol. (Oxf.) 36: 147, 1992.
Plockinger U., Reichel M., Fett U., Saeger W., Quabbe H.J. Preoperative octreotide treatment of growth hormone secreting and clinically non-functioning pituitary macroadenomas: effects on tumor volume and lack of correlation with immunohistochemistry and somatostatin receptor scintigraphy. J. Clin. Endocrinol. Metab. 79: 1416, 1994.
Colao A.M., Ferone D., Lastoria S., Marzullo P., Cerbone G., Di Sarno A., Longobardi S., Merola B., Salvatore M., Lombardi G. Prediction of efficacy of octreotide therapy in patients with acromegaly. J. Clin. Endocrinol. Metab. 81: 2356, 1996.
Ikuyama S., Nawata H., Kato K.I., Ibayashi H., Nakagaki H. Plasma growth hormone responses to somatostatin (SS) and SS receptors in pituitary adenomas in acromegalic patients. J. Clin. Endocrinol. Metab. 62: 729, 1986.
Reubi J.C., Landolt A.M. The growth hormone responses to octreotide in acromegaly correlate with adenoma somatostatin receptor status. J. Clin. Endocrinol. Metab. 68: 844, 1989.
Borson-Chazot F., Houzard C., Ajzenberg C., Nocaudiet M., Duet M., Mundler O., Marchandise X., Epelbaum J., Gomez de Algaza M., Schaefer J., Meyerhof W., Sassolas G., Warnet A. Somatostatin receptor imaging in somatotroph and nan-functioning pituitary adenomas: correlation with hormonal and visual responses to octreotide. Clin. Endocrinol. (Oxf.) 47: 589, 1997.
Oppizzi G., Dallabonzana D., Cozzi R. “Non secreting” pituitary tumors: a morphofunctional study. 3rd Int. Pituitary Congress, Marina del Rey, CA, USA, Abst TA-6, 1993.
De Bruin T.W.A., Kwekkeboom D.J., Van’t Verlaat J.W.I. Clinically non functioning pituitary adenoma and octreotide response to long term high dose treatment, and studies in vitro. J. Clin. Endocrinol. Metab. 75: 1310, 1992.
Warnet A., Timsit J., Chanson P. The effect of somatostatin analogue on chiasmal dysfunction from pituitary macroadenomas. J. Neurosurg. 71: 687, 1989.
Warnet A., Harris A., Renard E., Martin D., James-Deidier A., Chaumet-Riffaud P. A prospective multicentertrial of octreotide in 24 patients with visual defects caused by nonfunctioning and gonadotropin secreting pituitary adenomas. Neurosurgery 41: 786, 1997
Liuzzi A., Dallabonzana D., Oppizzi G.I. Is there a real medical treatment for “non-secreting” pituitary adenomas? In: Faglia G., Beck-Peccoz P., Ambrosi B., Travaglini P., Spada A. (Eds.), Pituitary adenomas: new trends in basic and clinical research. Excerpta Medica, Amsterdam, 1991, p 383.
Lamberts S.W.J., Uitterlinden P., Verschoor L., Van Dongen K.J., Del Pozo E. Long-term treatment of acromegaly with the somatostatin analogue SMS 201–995. N. Engl. J. Med. 313: 1576, 1985.
Chiodini P.G., Cozzi R., Dallabonzana D., Oppizzi G., Liuzzi A. Medical treatment of acromegaly with SMS 201–995, a somatostatin analog: a comparison with bromocriptine. J. Clin. Endocrinol. Metab. 64: 447, 1987.
Barkan A.L., Kelch R.P., Hopwood N.J., Beitins I.Z. Treatment of acromegaly with the long-acting somatostatin analog SMS 201–995. J. Clin. Endocrinol. Metab. 66: 16, 1988.
Dorr U., Wurm K., Horing E., Guzman G., Rath U., Bihl H. Diagnostic reliability of somatostatin receptor scintigraphy during continuous treatment with different somatostatin analogs. In: Somatostatin receptor imaging. 1st German Meeting, Stuttgart, Germany. Horm. Metab. Res. Suppl. no 27: 36, 1992.
Klibanski A., Bikkal H.A., Alexander J.M., Hsu D.W., Swearingen B., Zervas N.T. Somatostatin regulation of glycoprotein hormone and free subunit secretion in clinically nonfunctioning and somatotroph adenomas in vitro. J. Clin. Endocrinol. Metab. 73: 1248, 1991.
Spada A., Reza-Elahi F., Lania A., Gil-Del Alamo P., Bassetti M., Faglia G. Hypothalamic peptides modulate cytosolic free Ca2+-levels and adenylyl cyclase activity in human non-functioning pituitary adenomas. J. Clin. Endocrinol. Metab. 73: 913, 1991.
Kwekkeboom D.J., Krenning E.P., Lamberts S.W.J. In vitro studies in clinically non functioning pituitary adenomas. J. Endocrinol. Invest. 14(Suppl 1): 17 (abstract), 1991.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Oppizzi, G., Cozzi, R., Dallabonzana, D. et al. Scintigraphic imaging of pituitary adenomas: An in vivo evaluation of somatostatin receptors. J Endocrinol Invest 21, 512–519 (1998). https://doi.org/10.1007/BF03347337
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03347337