Head-to-head comparison of [ 11 C]methionine PET, [ 11 C]choline PET, and 4-dimensional CT as second-line scans for detection of parathyroid adenomas in primary hyperparathyroidism.
Autor: | Noltes ME; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.; Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.; Department of Surgery, Martini Hospital Groningen, Groningen, the Netherlands., Kruijff S; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.; Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.; Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden., Appelman APA; Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Jansen L; Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Zandee WT; Division of Endocrinology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Links TP; Division of Endocrinology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., van Hemel BM; Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Schouw HM; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.; Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Dierckx RAJO; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.; Department of Surgery, Martini Hospital Groningen, Groningen, the Netherlands., Francken AB; Department of Surgical Oncology, Isala, Zwolle, the Netherlands., Kelder W; Department of Surgery, Martini Hospital Groningen, Groningen, the Netherlands., van der Hoorn A; Department of Radiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands., Brouwers AH; Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands. a.h.brouwers@umcg.nl. |
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Jazyk: | angličtina |
Zdroj: | European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2024 Mar; Vol. 51 (4), pp. 1050-1059. Date of Electronic Publication: 2023 Nov 17. |
DOI: | 10.1007/s00259-023-06488-7 |
Abstrakt: | Purpose: Accurate preoperative localization is imperative to guide surgery in primary hyperparathyroidism (pHPT). It remains unclear which second-line imaging technique is most effective after negative first-line imaging. In this study, we compare the diagnostic effectiveness of [ 11 C]methionine PET/CT, [ 11 C]choline PET/CT, and four dimensional (4D)-CT head-to-head in patients with pHPT, to explore which of these imaging techniques to use as a second-line scan. Methods: We conducted a powered, prospective, blinded cohort study in patients with biochemically proven pHPT and prior negative or discordant first-line imaging consisting of ultrasonography and 99m Tc-sestamibi. All patients underwent [ 11 C]methionine PET/CT, [ 11 C]choline PET/CT, and 4D-CT. At first, all scans were interpreted by a nuclear medicine physician, and a radiologist who were blinded from patient data and all imaging results. Next, a non-blinded scan reading was performed. The scan results were correlated with surgical and histopathological findings. Serum calcium values at least 6 months after surgery were used as gold standard for curation of HPT. Results: A total of 32 patients were included in the study. With blinded evaluation, [ 11 C]choline PET/CT was positive in 28 patients (88%), [ 11 C]methionine PET/CT in 23 (72%), and 4D-CT in 15 patients (47%), respectively. In total, 30 patients have undergone surgery and 32 parathyroid lesions were histologically confirmed as parathyroid adenomas. Based on the blinded evaluation, lesion-based sensitivity of [ 11 C]choline PET/CT, [ 11 C]methionine PET/CT, and 4D-CT was respectively 85%, 67%, and 39%. The sensitivity of [ 11 C]choline PET/CT differed significantly from that of [ 11 C]methionine PET/CT and 4D-CT (p = 0.031 and p < 0.0005, respectively). Conclusion: In the setting of pHPT with negative first-line imaging, [ 11 C]choline PET/CT is superior to [ 11 C]methionine PET/CT and 4D-CT in localizing parathyroid adenomas, allowing correct localization in 85% of adenomas. Further studies are needed to determine cost-benefit and efficacy of these scans, including the timing of these scans as first- or second-line imaging techniques. (© 2023. The Author(s).) |
Databáze: | MEDLINE |
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