The role of 18 F-fluoromethylcholine-positron emission tomography-computed tomography for preoperative localization of hyperfunctioning parathyroid glands with special emphasis on multiglandular disease: a retrospective cohort study.
| Autor: | Murad H; Department of Surgery, Highland Hospital, Eksjö, Sweden., Ciacoi-Dutu C; Department of Nuclear Medicine, Ryhov Hospital, Jönköping, Sweden., Lindblom G; Department of Nuclear Medicine, Ryhov Hospital, Jönköping, Sweden., Almquist M; Department of Surgery and Department of Clinical Sciences, Skåne University Hospital, Lund University, Lund, Sweden. |
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| Jazyk: | angličtina |
| Zdroj: | Gland surgery [Gland Surg] 2023 Nov 24; Vol. 12 (11), pp. 1567-1578. Date of Electronic Publication: 2023 Nov 15. |
| DOI: | 10.21037/gs-23-232 |
| Abstrakt: | Background: Primary hyperparathyroidism (PHPT) is a common endocrine disorder. Definitive treatment is surgical. Preoperative localization of diseased glands increases the chance of successful treatment. The aim of this study is to investigate the diagnostic performance of 18 F-fluoromethylcholine-positron emission tomography-computed tomography ( 18 F-FCh-PET-CT) in preoperative localization of diseased parathyroid glands, when first-line examinations were inconclusive. Methods: This is a retrospective study. All patients with PHPT who underwent 18 F-FCh-PET-CT, after inconclusive ultrasound examination and 99m Tc-methoxyisobutylisonitrile/single-photon emission CT-CT, were included in cohort I. Patients who were subsequently operated for their parathyroid disease, were included in cohort II. The performance of 18 F-FCh-PET-CT was analyzed in two sets: per-lesion, and per-gland analysis. Results: Out of 52 patients in cohort I, 18 F-FCh-PET-CT identified single or multiple parathyroid lesions in 43 patients (83%). Nine patients had multiglandular disease. Thirty-four (65%) patients were subsequently operated and included in cohort II. Forty-four lesions were removed from these patients and 33 patients (97%) were cured. 18 F-FCh-PET-CT localized 40 out of 44 lesions, with per-lesion and per-gland sensitivities of 97% and 95%, and positive predictive values (PPVs) of 93% and 87%, respectively, in addition to a specificity of 97% and a negative predictive value (NPV) of 94% in the per-gland analysis. Comparable excellent results were detected in multiglandular disease with sensitivity of 94.1%, specificity of 89%, PPV of 84%, and NPV of 94%. Conclusions: Our study demonstrates the high diagnostic performance of 18 F-FCh-PET-CT in the preoperative localization of diseased parathyroid gland in patients with PHPT, especially in multiglandular PHPT. Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-23-232/coif). The authors have no conflicts of interest to declare. (2023 Gland Surgery. All rights reserved.) |
| Databáze: | MEDLINE |
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