Localization of parathyroid adenomas using 11C-methionine pet after prior inconclusive imaging
Autor: | Bart Dorgelo, Schelto Kruijff, Milou E Noltes, Anouk N A van der Horst-Schrivers, Adrienne H. Brouwers, Annemieke M Coester, Clara Lemstra, Walter Noordzij, Liesbeth Jansen |
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Přispěvatelé: | Guided Treatment in Optimal Selected Cancer Patients (GUTS), Vascular Ageing Programme (VAP), Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE) |
Jazyk: | angličtina |
Rok vydání: | 2017 |
Předmět: |
Male
medicine.medical_treatment Scintigraphy GUIDELINES 030218 nuclear medicine & medical imaging 0302 clinical medicine Methionine Minimally invasive parathyroidectomy (MIP) ULTRASONOGRAPHY Positron Emission Tomography Computed Tomography 11C-methionine positron emission tomography (11C-MET PET) Carbon Radioisotopes PRIMARY HYPERPARATHYROIDISM ULTRASOUND Parathyroid adenoma Aged 80 and over medicine.diagnostic_test Parathyroid neoplasm C-11-methionine positron emission tomography (C-11-MET PET) Middle Aged SECONDARY HYPERPARATHYROIDISM Parathyroid Neoplasms Positron emission tomography 030220 oncology & carcinogenesis Primary hyperparathyroidism (pHPT) Original Article Female Radiology Parathyroidectomy Adenoma Adult medicine.medical_specialty Sensitivity and Specificity 03 medical and health sciences Young Adult POSITRON-EMISSION-TOMOGRAPHY medicine Humans METAANALYSIS Aged Retrospective Studies business.industry SPECT/CT medicine.disease PREOPERATIVE LOCALIZATION Surgery SCINTIGRAPHY Nuclear medicine business Primary hyperparathyroidism Abdominal surgery |
Zdroj: | Langenbecks Archives of Surgery, 402(7), 1109-1117. SPRINGER Langenbeck's Archives of Surgery |
ISSN: | 1435-2443 |
Popis: | Purpose: Minimally invasive parathyroidectomy (MIP) is the recommended treatment in primary hyperparathyroidism (pHPT) for which accurate preoperative localization is essential. The current imaging standard consists of cervical ultrasonography (cUS) and MIBI-SPECT/CT. 11C-MET PET/CT has a higher resolution than MIBI-SPECT/CT. The aim of this study was to determine the diagnostic performance of 11CMET PET/CT after initial inconclusive or negative localization. Methods: We performed a retrospective single center cohort study of patients with pHPT undergoing parathyroid surgery after prior negative imaging and later localization by means of 11C-MET PET/CT between 2006 and 2014. Preoperative localization by 11C-MET PET/CT was compared with later surgical localization, intraoperative quick PTH (IOPTH), duration of surgery, histopathology, and follow-up data. Also, differences in duration of surgery between the groups with and without correct preoperative localization were analyzed. Results: In 18/28 included patients a positive 11C-MET-PET/CT result corresponded to the surgical localized adenoma (64%). In 3/28 patients imaging was false positive and no adenoma was found. In 7/28 patients imaging was false negative at the side of the surgically identified adenoma. Sensitivity of 11C-MET PET/ CT was 72% (18/25). Duration of surgery of correctly localized patients was significantly shorter compared to falsely negative localized patients (p = 0.045). Conclusion: In an intention to treat 11C-MET-PET/CT correctly localized the parathyroid adenoma in 18/28 (64%) patients, after previous negative imaging. A preoperatively correct localized adenoma leads to a more focused surgical approach (MIP) potentially reducing duration of surgery and potentially healthcare costs. |
Databáze: | OpenAIRE |
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