Retrospective real-life study on preoperative imaging for minimally invasive parathyroidectomy in primary hyperparathyroidism

Autor: Jacqueline Bijnens, Annick Van den Bruel, Vincent Vander Poorten, Ingeborg Goethals, Steven Van Schandevyl, Catherine Dick, Frank De Geeter
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Scientific Reports, Vol 12, Iss 1, Pp 1-8 (2022)
Druh dokumentu: article
ISSN: 2045-2322
DOI: 10.1038/s41598-022-18219-3
Popis: Abstract The objective of this study was to retrospectively evaluate preoperative imaging modalities for localization of parathyroid adenomas with a view to enable minimally invasive parathyroidectomy and in particular, to consider the contribution of 18F-fluorocholine-PET/CT. 104 patients with primary hyperparathyroidism, who underwent parathyroid surgery in a single centre during a 6-year period were included. Of these, 103 underwent ultrasound, 97 99mTc-Pertechnetate/SestaMIBI-SPECT, 20 MRI and 30 18F-fluorocholine-PET/CT. Based on surgical findings, sensitivities and specificities for correct lateralisation in orthotopic locations were: for ultrasound 0.75 (0.65–0.83) and 0.89 (0.81–0.94), for 99mTc-MIBI-SPECT 0.57 (0.46–0.67) and 0.97 (0.91–0.99), for MRI 0.60 (0.36–0.81) and 0.83 (0.59–0.96) and for 18F-fluorocholine-PET/CT 0.90 (0.73–0.98) and 0.90 (0.73–0.98). Correctly lateralized adenomas were significantly larger than those not found with ultrasound (p = 0.03) and SPECT (p = 0.002). Pre-operative PTH-levels were higher in single adenomas detected by scintigraphy than in those not (p = 0.02). 64 patients could be treated with a minimally invasive procedure. Cure after parathyroidectomy was obtained in 94% of patients. 18F-Fluorocholine-PET/CT could be shown to be a highly accurate modality to localize parathyroid adenomas preoperatively, obviating the need for total exploration in the majority of patients in whom ultrasound and scintigraphic results are discordant or both negative.
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