The use of (11)carbon methionine positron emission tomography (PET) imaging to enhance radiotherapy planning in the treatment of a giant, invasive pituitary adenoma

A 54-year-old male presented with visual loss owing to a giant, infiltrative pituitary adenoma. Following decompressive trans-sphenoidal surgery, the patient was referred for adjuvant radiotherapy. We describe the potential utility of (11)carbon methionine positron emission tomography imaging in confirming the true extent of tumour infiltration, which included the cavernous sinuses and the bones of the skull base. The co-registration of positron emission tomography imaging to planning MR and CT imaging provided assurance of complete radiotherapy coverage of the target volume and assisted with the minimisation of collateral radiation dose to adjacent organs at risk.