Theresia Weber1, Martin Gottstein2, Sabrina Schwenzer2, Ambros Beer2, Markus Luster3. 1. Department of Endocrine Surgery, Katholisches Klinikum Mainz, An der Goldgrube 11, 55131, Mainz, Germany. t-weber@kkmainz.de. 2. Department of Nuclear Medicine, University Medical Center Ulm, Ulm, Germany. 3. Department of Nuclear Medicine, University of Marburg, Marburg, Germany.
Abstract
BACKGROUND: Patients with primary hyperparathyroidism (pHPT) and a negative preoperative Tc-99 sestamibi (MIBI) scintigraphy are considered to have a higher risk of persistent disease. The aim of this study was to assess whether additional imaging with C-11 methionine positron emission tomography/computed tomography (Met-PET/CT) is able to localise sestamibi-negative hyperfunctioning parathyroid glands. METHODS: In 50 patients (38 females, 12 males, age 13-81 years) with pHPT and negative localisation procedures such as ultrasound and sestamibi, a Met-PET/CT was performed before parathyroid surgery. The results of Met-PET/CT were analysed prospectively and compared with intraoperative and histopathological findings. 22% of the patients underwent previous parathyroid and/or thyroid surgery. RESULTS: Met-PET/CT correctly located a single-gland adenoma in 33 of 45 (73%) patients with pHPT. In 5 patients with multiglandular disease, Met-PET/CT detected at least one hyperfunctional parathyroid gland in 4 patients (80%). In 3 patients with double adenomas, 5 of 6 parathyroids were correctly located. Overall, 40 of 57 (70%) hyperfunctioning glands were identified with Met-PET/CT. Met-PET/CT was false-negative in 12 of 50 (24%) patients and false-positive in only one case (2%). Postoperatively, 48 of 50 patients (96%) were cured. CONCLUSIONS: Additional pre-interventional imaging with Met-PET/CT was able to identify hyperfunctioning parathyroid glands in 74% of patients with pHPT and negative sestamibi scans, thus enabling successful parathyroid surgery.
BACKGROUND:Patients with primary hyperparathyroidism (pHPT) and a negative preoperative Tc-99 sestamibi (MIBI) scintigraphy are considered to have a higher risk of persistent disease. The aim of this study was to assess whether additional imaging with C-11 methionine positron emission tomography/computed tomography (Met-PET/CT) is able to localise sestamibi-negative hyperfunctioning parathyroid glands. METHODS: In 50 patients (38 females, 12 males, age 13-81 years) with pHPT and negative localisation procedures such as ultrasound and sestamibi, a Met-PET/CT was performed before parathyroid surgery. The results of Met-PET/CT were analysed prospectively and compared with intraoperative and histopathological findings. 22% of the patients underwent previous parathyroid and/or thyroid surgery. RESULTS: Met-PET/CT correctly located a single-gland adenoma in 33 of 45 (73%) patients with pHPT. In 5 patients with multiglandular disease, Met-PET/CT detected at least one hyperfunctional parathyroid gland in 4 patients (80%). In 3 patients with double adenomas, 5 of 6 parathyroids were correctly located. Overall, 40 of 57 (70%) hyperfunctioning glands were identified with Met-PET/CT. Met-PET/CT was false-negative in 12 of 50 (24%) patients and false-positive in only one case (2%). Postoperatively, 48 of 50 patients (96%) were cured. CONCLUSIONS: Additional pre-interventional imaging with Met-PET/CT was able to identify hyperfunctioning parathyroid glands in 74% of patients with pHPT and negative sestamibi scans, thus enabling successful parathyroid surgery.
Authors: Tatjana Traub-Weidinger; Marius E Mayerhoefer; Oskar Koperek; Markus Mitterhauser; Heying Duan; Georgios Karanikas; Bruno Niederle; Martha Hoffmann Journal: J Clin Endocrinol Metab Date: 2014-07-16 Impact factor: 5.958
Authors: Dina M Elaraj; Rebecca S Sippel; Sheila Lindsay; Ileana Sansano; Quan-Yang Duh; Orlo H Clark; Electron Kebebew Journal: Arch Surg Date: 2010-06
Authors: Anders O J Bergenfelz; Svante K G Jansson; Göran K Wallin; Hans G Mårtensson; Lars Rasmussen; Håkan L O Eriksson; Eva I M Reihnér Journal: Langenbecks Arch Surg Date: 2009-07-18 Impact factor: 3.445
Authors: Camilla Schalin-Jäntti; Eeva Ryhänen; Ilkka Heiskanen; Marko Seppänen; Johanna Arola; Jukka Schildt; Mika Väisänen; Lassi Nelimarkka; Irina Lisinen; Ville Aalto; Pirjo Nuutila; Matti J Välimäki Journal: J Nucl Med Date: 2013-04-03 Impact factor: 10.057
Authors: Akinyemi A Akintayo; O A Abiodun-Ojo; C Weber; J Sharma; C Cohen; G Sica; R Halkar; M M Goodman; D M Schuster Journal: Mol Imaging Biol Date: 2019-10 Impact factor: 3.488
Authors: M E Noltes; S Kruijff; L Jansen; H E Westerlaan; W T Zandee; R A J O Dierckx; A H Brouwers Journal: EJNMMI Res Date: 2021-03-26 Impact factor: 3.138