Fig. 4.
PET–guided stereotactic radiosurgery in case 10. A–B Post-contrast coronal T1 SE and FSPGR MRI demonstrate indeterminate appearances in a patient who had previously undergone transsphenoidal surgery for a left-sided microprolactinoma. C Axial FSPGR MRI shows possible recurrent tumor in the left cavernous sinus (yellow arrow). D–E Coronal and axial Met-PET/MRCR confirm avid tracer uptake at the site of the suspected recurrence (yellow arrow); tracer uptake within the remaining normal gland is also seen (white arrow). F Treatment plan for PET-guided SRS. Three years later serum prolactin was near-normalized (1.4 × ULN). FSPGR fast spoiled gradient recalled echo, Gad gadolinium, MRI magnetic resonance imaging, Met-PET/MRCR 11C-methionine PET-CT coregistered with volumetric (FSPGR) MRI, PET positron emission tomography, PTV Planning Target Volume, SE spin echo, ULN upper limit of normal