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
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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