News | December 05, 2014

PET/CT Shows Pituitary Abnormalities in Veterans with PTSD

HPA axis suspected of playing crucial role in PTSD

Nuclear imaging, PET/CT, Clinical Trial/Study, RSNA 2014

PET/CT on the left and an MRI on the right demonstrating the relative locations of both the Hypothalamus and the Pituitary.

December 5, 2014 — Hybrid imaging with positron emission tomography and computed tomography (PET/CT) in the pituitary region of the brain is a promising tool for differentiating military veterans with post-traumatic stress disorder (PTSD) from those with mild traumatic brain injury (MTBI), according to a new study presented at RSNA 2014.

The findings also lend support to the theory that many veterans diagnosed with PTSD may actually have hormonal irregularities due to pituitary gland damage from blast injury.

MTBI involves damage to the brain from an external force, while PTSD is generally defined as a mental health condition that can develop after someone has experienced a traumatic event. Research has shown that up to 44 percent of returning veterans with MTBI and loss of consciousness also meet the criteria for PTSD. Differentiating PTSD from MTBI can be challenging for clinicians due to symptom overlap and, in many cases, normal structural neuroimaging results.

Researchers recently used PET/CT to study the hypothalamus and pituitary glands of veterans who had suffered blast-related MTBI. The pituitary gland is a pea-sized structure that sits in the bony enclosure located at the base of the skull and is connected to a part of the brain called the hypothalamus. Together with the adrenal glands above each kidney, the hypothalamus and pituitary gland form the HPA axis, an important regulator of many body processes, including stress response, mood and energy expenditure.

The researchers focused on 18F-fluorodeoxyglucose (18F-FDG) PET/CT, which provides a picture of metabolism by measuring uptake of the radiopharmaceutical FDG. A review of 159 brain 18F-FDG PET/CT exam records showed that FDG uptake in the hypothalamus was significantly lower in the MTBI-only group compared with normal controls. FDG uptake in the pituitary gland was significantly higher in the MTBI and PTSD group compared with the MTBI-only group.

The finding of higher FDG uptake in the pituitary glands of PTSD sufferers supports the theory that many veterans diagnosed with PTSD may actually have hypopituitarism, a condition in which the pituitary gland does not produce normal amounts of one or more of its hormones.

"This raises the possibility that some PTSD cases are actually hypopituitarism masking itself as PTSD," Malone said. "If that's the case, then we might be able to help those patients by screening for hormone irregularities and treating those irregularities on an individual basis."

Malone said the increased FDG uptake in the pituitary glands of veterans with MTBI and PTSD may be due to the gland working harder to produce hormones.

The results suggest that PET/CT may provide an effective way to diagnose and differentiate PTSD from MTBI and offer more insight into the biological manifestations of the disorder.

Malone comments: "Currently, treatment for PTSD is typically limited to psychological therapy, antidepressants and anxiety medications. Our findings reinforce the theory that there is something physically and biologically different in veterans who have MTBI and PTSD compared to those who just have MTBI."

Co-authors on the study include Osama A. Raslan, M.D., M.B., B.Ch.; Diane M. Whitson, M.P.H.; Razi Muzaffar, D.O., P.T. Roskos, Ph.D.; Patrick V. Kelly, Ph.D.; Richard R. Buchholz, M.D. and Medhat M. Osman, M.D.

For more information: www.rsna.org

 

Related Content

Partial Breast Irradiation Effective, Convenient Treatment Option for Low-Risk Breast Cancer
News | Radiation Therapy | May 20, 2019
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast...
AI Detects Unsuspected Lung Cancer in Radiology Reports, Augments Clinical Follow-up
News | Artificial Intelligence | May 20, 2019
Digital Reasoning announced results from its automated radiology report analytics research. In a series of experiments...
New Study Evaluates Head CT Examinations and Patient Complexity
News | Neuro Imaging | May 17, 2019
Computed tomography (CT) of the head uses special X-ray equipment to help assess head injuries, dizziness and other...
New Phase 2B Trial Exploring Target-Specific Myocardial Ischemia Imaging Agent
News | Radiopharmaceuticals and Tracers | May 17, 2019
Biopharmaceutical company CellPoint plans to begin patient recruitment for its Phase 2b cardiovascular imaging study in...
Managing Architectural Distortion on Mammography Based on MR Enhancement
News | Mammography | May 15, 2019
High negative predictive values (NPV) in mammography architectural distortion (AD) without ultrasonographic (US)...
Icon Launches New Clinical Trial Patient Engagement Platform
Technology | Patient Engagement | May 14, 2019
Icon plc announced the release of its web-based clinical trial patient engagement platform, to provide patients with...
Blue Earth Diagnostics Expands Access to Axumin in Europe
News | Radiopharmaceuticals and Tracers | May 13, 2019
Blue Earth Diagnostics announced expanded access to the Axumin (fluciclovine (18F)) imaging agent in Europe. The first...
Radiotherapy After Chemo May Improve Survival in Advanced Hodgkin's Lymphoma Patients
News | Radiation Therapy | May 10, 2019
Patients with advanced Hodgkin's lymphoma who have large tumors at the time of diagnosis may benefit from radiotherapy...
Shine Medical Technologies Breaks Ground on U.S. Medical Isotope Production Facility

Image courtesy of Amen Clinics

News | Radiopharmaceuticals and Tracers | May 10, 2019 | Jeff Zagoudis, Associate Editor
Shine Medical Technologies Inc. broke ground on their first medical isotope production facility in Janesville, Wis. U.S...
Screening MRI Detects BI-RADS 3 Breast Cancer in High-risk Patients
News | MRI Breast | May 09, 2019
When appropriate, short-interval follow-up magnetic resonance imaging (MRI) can be used to identify early-stage breast...