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. 2022 Jun 6;25(5):709–712. doi: 10.1007/s11102-022-01236-w

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — MRI and Met-PET findings with 3D reconstruction of the sella and parasellar regions in a patient with ACTH-dependent Cushing’s syndrome. A–C Pre- and post-contrast coronal T1w SE MRI (A, B) and FSPGR (volumetric) MRI (C) demonstrate equivocal appearances, with subtle deviation of the infundibulum to the left, but minor downward sloping of the floor of the sella on the left side. No discrete microadenoma is readily visualized. D Met-PET/MR^CR reveals both central (white arrow) and right-sided (yellow arrow) radiotracer uptake in the gland. E, F 3D reconstructed images, combining PET, CT and FSPGR MRI datasets, allows appreciation of the location of the tumor (yellow) with respect to the normal gland (turquoise) and other adjacent structures including the intracavernous carotid arteries (red) and optic chiasm (green). G Profiling of ¹¹C-methionine uptake across the sella reveals two peaks consistent with uptake by normal gland and a corticotroph microadenoma. At transsphenoidal surgery, a microadenoma was resected from the right side of the gland and confirmed histologically to be a corticotroph adenoma. Postoperatively the patient achieved complete clinical and biochemical remission and remains eupituitary. Key: CT computed tomography; FSPGR fast spoiled gradient recalled echo; Gad gadolinium; Met-PET/MR^CR ¹¹C-methionine PET-CT coregistered with volumetric (FSPGR) MRI; MRI magnetic resonance imaging; PET positron emission tomography; SE spin echo; T1w T1-weighted