Osilodrostat and 11C-methionine PET in Cushing's disease

  • Research type

    Research Study

  • Full title

    Osilodrostat therapy and 11C-methionine PET/CT to IMprove corticotroph pituitary Adenoma detection and Localisation in patients with Cushing's disease

  • IRAS ID

    335101

  • Contact name

    Florian Wernig

  • Contact email

    f.wernig@imperial.ac.uk

  • Sponsor organisation

    Imperial College London

  • Duration of Study in the UK

    3 years, 0 months, 1 days

  • Research summary

    Cushing's disease is a rare condition caused by an adenoma in the pituitary gland. This adenoma is a non-cancerous growth and is made of cells which produce large amounts of adrenocorticotrophic hormone (ACTH), which in turn causes increased production of the hormone cortisol. High cortisol levels can have a significant negative impact on health and quality of life.
    Where the pituitary adenoma can be seen on a special brain scan, called MRI, surgery can be successful in 70%, but in up to half of patients, the adenoma cannot be seen on MRI which makes surgical removal very difficult. It is important to lower cortisol levels as effectively as possible to minimise harm from hormone excess, either whilst waiting for surgery or as an alternative to surgery if the pituitary adenoma cannot be seen on MRI. However, current medications to lower cortisol have significant side effects and are not always effective. A new cortisol-lowering medication called osilodrostat has been shown to effectively lower cortisol levels and to improve symptoms of Cushing's disease. In recent studies, a new imaging technique called 11C-methionine PET CT has shown promising results in identifying pituitary adenomas which can’t be seen using standard MRI. In patients with Cushing’s disease caused by a pituitary adenoma which is not clearly visualised by MRI. Interval/ repeat scanning with 11C-methionine PET CT after a period of medical treatment may help make these adenomas more visible. Patients with Cushing’s disease will have a pituitary MRI scan and 11C-methionine PET CT scan at the time of diagnosis and after a treatment period with osilodrostat (3 months of normal cortisol levels). The aim of this study is to see whether interval scanning with MRI and 11C-methionine PET will improve detection and localisation of ACTH-producing pituitary adenomas (the cause of Cushing's disease).

  • REC name

    East Midlands - Nottingham 1 Research Ethics Committee

  • REC reference

    24/EM/0178

  • Date of REC Opinion

    29 Oct 2024

  • REC opinion

    Further Information Favourable Opinion