18 F-choline PET/4D CT in hyperparathyroidism: correlation between biochemical data and study parameters.

Autor: Boccalatte LA; Sección Cirugía de Cabeza y Cuello, Servicio de Cirugía General, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: luis.boccalatte@hospitalitaliano.org.ar., Gómez NL; Sección Cirugía de Cabeza y Cuello, Servicio de Cirugía General, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Musumeci M; Medicina Nuclear, Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Galich AM; Sección Metabolismo Fosfocálcico, Servicio de Endocrinología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Collaud C; Medicina Nuclear, Servicio de Diagnóstico por Imágenes, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Figari MF; Sección Cirugía de Cabeza y Cuello, Servicio de Cirugía General, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de medicina nuclear e imagen molecular [Rev Esp Med Nucl Imagen Mol (Engl Ed)] 2020 Sep - Oct; Vol. 39 (5), pp. 273-278. Date of Electronic Publication: 2020 Jun 12.
DOI: 10.1016/j.remn.2020.03.017
Abstrakt: Background: Hyperparathyroidism (HPT) is characterised by increased levels of parathyroid hormone (HPT), surgical excision being the only definitive curative option. After establishing the need for surgery, it is essential to identify the parathyroid glands in the preoperative period to use a minimally invasive approach. Negativity and / or discrepancy in first-line studies (ultrasound and Tc-99m MIBI parathyroid scintigraphy) require more accurate images to reduce the likelihood of bilateral cervical exploration or reintervention.
Objectives: a) To demonstrate the sensitivity of 18 F-fluorocholine ( 18 F-choline) positron emission tomography (PET)/4D computed tomography (4D CT) in HPT. b) To check whether there is a correlation between calcaemia and preoperative PTH versus size and early and late SUVmax (Standardized Uptake Value) of the gland, determined by 18 F-choline PET/4D CT and c) to study the behaviour of parathyroid lesions with intravenous contrast (IV).
Material and Methods: A total of 28 patients were included between 2016 and 2019 in a single institution. Prospective observational cohort study. Correlations were analysed using Pearson's coefficient for variables with normal distribution and Spearman (rho) for those with non-normal distribution. Anatomopathological analysis was the benchmark standard to determine sensitivity was. A p<.05 was interpreted as significant. STATA 13 software was used.
Results: Of the 28 patients who underwent 18 F-choline PET/4D CT, 18 were operated. Of the 26 lesions diagnosed by 18 F-choline PET/4D CT as suggestive of parathyroid lesions, 23 corresponded to glandular disease (adenoma or hyperplasia) establishing a sensitivity of 88.5%. There was a correlation between the patient's preoperative PTH and the maximum size of the gland on 18 F-choline PET/4D CT. (Spearman=.66; p=.0014). The parathyroid lesions showed, in addition to IV contrast enhancement, distinctive behavioural characteristics identified as highly suggestive.
Conclusions: 18F-choline PET/CT 4D is an anatomical and functional study with high sensitivity in patients with HPT with negative or discrepant first-line studies. Preoperative PTH showed a correlation with maximum gland size on 18 F-choline PET/CT 4D. Parathyroid lesions behave in a highly suggestive way and are enhanced by IV contrast.
(Copyright © 2020 Sociedad Española de Medicina Nuclear e Imagen Molecular. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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