PMC6612391_01
Evolution of brain MRI during follow-up. At diagnosis, the normal T1-weighted hyperintense signal of the posterior pituitary has disappeared (a). Contrast-enhanced hypothalamic mass after gadolinium infusion ((b) and (c)); compression of third ventricle and thickening of pituitary stalk (b). Comparison of brain MRI (T1 with gadolinium) at diagnosis (M0) (d) and at the end of the first-line therapy (e). MRI showed a significant decrease of the hypothalamic mass but the persistence of contrast enhancement after gadolinium. Brain MRI (T1 after gadolinium infusion) at M30 showing a hypothalamic lesion stable in size and with decreased hypersignal compared to previous MRI (f).
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fig1
A strong contrast enhancement was observed after administration of gadolinium (Figures 1(a), 1(b), and 1(c)). Although a significant decrease of the size of the brain mass was observed when compared to initial evaluation, persistence of contrast enhancement after gadolinium administration suggested an incomplete response to therapy (Figures 1(d) and 1(e)). At M30, brain MRI showed a decrease of both tumor volume and contrast enhancement (Figure 1(f)).
Sagittal PET-MRI brain imaging. Sagittal PET-MRI brain imaging with [18F]FDG at M32 (a, a1, a2) and at M35 (b, b1, b2) of follow-up. Nodular thickening of the floor of the third ventricle and pituitary infundibulum, in hyperintense FLAIR, without [18F]FDG-uptake, measuring 7 mm in height x 13 mm in the axial plane, without significant enhancement, globally unchanged from the previous MRI. Linear and fine enhancement of the pituitary infundibulum with stable appearance.
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fig2
The PET-MRI made during the relapse of diabetes at M32 showed a nodular thickening of the floor of the third ventricle and pituitary infundibulum with no [18F]-FDG-uptake (Figures 2 and 3). Control of diabetes was maintained until M35 and PET-MRI was unchanged at that time (Figures 2 and 3).
Axial PET-MRI brain imaging. Axial PET-MRI brain imaging with [18F]FDG at M32 (a, a1, a2) and at M35 (b, b1, b2) of follow-up.
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fig3
The PET-MRI made during the relapse of diabetes at M32 showed a nodular thickening of the floor of the third ventricle and pituitary infundibulum with no [18F]-FDG-uptake (Figures 2 and 3). Control of diabetes was maintained until M35 and PET-MRI was unchanged at that time (Figures 2 and 3).