Four-dimensional computed tomography as first-line imaging in primary hyperparathyroidism, a retrospective comparison to conventional imaging in a predominantly single adenoma population.

Autor: Krol JP; Department of Radiology & Nuclear Medicine, Rijnstate Hospital, Wagnerlaan 55, Arnhem, 6815AD, The Netherlands. j.p.krol@utwente.nl.; Department of Robotics and Mechatronics, Faculty of Electrical Engineering, Mathematics and Computer Sciences, University of Twente, Enschede, The Netherlands. j.p.krol@utwente.nl., Joosten FBM; Department of Radiology & Nuclear Medicine, Rijnstate Hospital, Wagnerlaan 55, Arnhem, 6815AD, The Netherlands., de Boer H; Department of Internal Medicine, Rijnstate Hospital, Arnhem, The Netherlands., Bernsen MLE; Department of Radiology & Nuclear Medicine, Rijnstate Hospital, Wagnerlaan 55, Arnhem, 6815AD, The Netherlands., Slump CH; Department of Robotics and Mechatronics, Faculty of Electrical Engineering, Mathematics and Computer Sciences, University of Twente, Enschede, The Netherlands., Oyen WJG; Department of Radiology & Nuclear Medicine, Rijnstate Hospital, Wagnerlaan 55, Arnhem, 6815AD, The Netherlands.; Department of Biomedical Sciences and Humanitas Clinical and Research Centre, Department of Nuclear Medicine, Humanitas University, Milan, Italy.; Department of Radiology & Nuclear Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: EJNMMI reports [EJNMMI Rep] 2024 May 01; Vol. 8 (1), pp. 11. Date of Electronic Publication: 2024 May 01.
DOI: 10.1186/s41824-024-00198-5
Abstrakt: Background: To determine the use of four-dimensional CT as first-line imaging compared to the traditional combination of ultrasound and [ 99m Tc]Tc-Sestamibi SPECT.
Materials and Methods: Retrospective review of preoperative imaging in patients with primary hyperparathyroidism, who underwent parathyroidectomy between 2012 and 2021. In one group, the combination ultrasound and [ 99m Tc]Tc-Sestamibi SPECT was used as first-line imaging (n = 54), in the other group four-dimensional CT was the first-line imaging modality (n = 51). Sensitivity and positive predictive value were calculated on patient, lateralisation and localisation level. The need for additional imaging was also assessed for both groups.
Results: Four-dimensional CT had a significantly higher sensitivity compared to the combination of ultrasound/[ 99m Tc]Tc-Sestamibi SPECT on patient and localisation level (70.6% vs. 51.9%, p = 0.049 and 60.8% vs. 35.2%, p = 0.009 respectively). Sensitivity for lateralisation also appeared higher, but did not reach significance (62.7% vs. 44.4%, p = 0.060). Positive predictive value was not significantly higher for four-dimensional CT compared to ultrasound and [ 99m Tc]Tc-Sestamibi SPECT (88.9% vs. 85.7% for lateralisation and 86.1% vs. 67.9% for localisation respectively). Additional imaging was required in 14 patients with four-dimensional CT as first-line imaging (27.4%) consisting of 2 ultrasound/[ 99m Tc]Tc-Sestamibi SPECT and 13 [ 18 F]fluorocholine PET/CT, compared to 24 patients with ultrasound/[ 99m Tc]Tc-Sestamibi SPECT as first-line imaging (44.4%), requiring 22 four-dimensional CT and 9 [ 18 F]fluorocholine PET/CT.
Conclusions: Four-dimensional CT as the sole first-line parathyroid imaging modality had higher sensitivity than the combination of ultrasound and [ 99m Tc]Tc-Sestamibi SPECT, therefore requiring fewer additional procedures. Although the most costly, [ 18 F]fluorocholine PET/CT was the most effective technique to localise parathyroid adenoma in case all other imaging was negative.
(© 2024. The Author(s).)
Databáze: MEDLINE
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