Thomas A Hope1,2, Claire E Graves3, Jeremie Calais4, Eric C Ehman5, Geoffrey B Johnson5,6, Daniel Thompson1, Maya Aslam1, Quan-Yang Duh3, Jessica E Gosnell3, Wen T Shen3, Sanziana A Roman3, Julie A Sosa3, Wouter P Kluijfhout7, Carolyn D Seib8, Javier E Villaneuva-Meyer1, Miguel H Pampaloni1, Insoo Suh9,10. 1. Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California. 2. Department of Radiology, San Francisco VA Medical Center, San Francisco, California. 3. Department of Surgery, University of California San Francisco, San Francisco, California. 4. Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, UCLA, Los Angeles, California. 5. Department of Radiology, Mayo Clinic, Rochester, Minnesota. 6. The Department of Immunology, Mayo Clinic, Rochester, Minnesota. 7. Department of Surgical Oncology and Endocrine Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 8. Department of Surgery, Stanford University, Stanford, California; and. 9. Department of Surgery, University of California San Francisco, San Francisco, California; insoo.suh@ucsf.edu. 10. Department of Surgery, New York University Langone Health, New York, New York.
Abstract
The purpose of this prospective study was to determine the correct localization rate (CLR) of 18F-fluorocholine PET for the detection of parathyroid adenomas in comparison to 99mTc-sestamibi imaging. Methods: This was a single-arm prospective trial. Ninety-eight patients with biochemical evidence of primary hyperparathyroidism were imaged before parathyroidectomy using 18F-fluorocholine PET/MRI. 99mTc-sestamibi imaging performed separately from the study was evaluated for comparison. The primary endpoint of the study was the CLR on a patient level. Each imaging study was interpreted by 3 masked readers on a per-region basis. Lesions were validated by histopathologic analysis of surgical specimens. Results: Of the 98 patients who underwent 18F-fluorocholine PET, 77 subsequently underwent parathyroidectomy and 60 of those had 99mTc-sestamibi imaging. For 18F-fluorocholine PET in patients who underwent parathyroidectomy, the CLR based on the masked reader consensus was 75% (95% CI, 0.63-0.82). In patients who underwent surgery and had an available 99mTc-sestamibi study, the CLR increased from 17% (95% CI, 0.10-0.27) for 99mTc-sestamibi imaging to 70% (95% CI, 0.59-0.79) for 18F-fluorocholine PET. Conclusion: In this prospective study using masked readers, the CLR for 18F-fluorocholine PET was 75%. In patients with a paired 99mTc-sestamibi study, the use of 18F-fluorocholine PET increased the CLR from 17% to 70%. 18F-fluorocholine PET is a superior imaging modality for the localization of parathyroid adenomas.
The purpose of this prospective study was to determine the correct localization rate (CLR) of 18F-fluorocholine PET for the detection of parathyroid adenomas in comparison to 99mTc-sestamibi imaging. Methods: This was a single-arm prospective trial. Ninety-eight patients with biochemical evidence of primary hyperparathyroidism were imaged before parathyroidectomy using 18F-fluorocholine PET/MRI. 99mTc-sestamibi imaging performed separately from the study was evaluated for comparison. The primary endpoint of the study was the CLR on a patient level. Each imaging study was interpreted by 3 masked readers on a per-region basis. Lesions were validated by histopathologic analysis of surgical specimens. Results: Of the 98 patients who underwent 18F-fluorocholine PET, 77 subsequently underwent parathyroidectomy and 60 of those had 99mTc-sestamibi imaging. For 18F-fluorocholine PET in patients who underwent parathyroidectomy, the CLR based on the masked reader consensus was 75% (95% CI, 0.63-0.82). In patients who underwent surgery and had an available 99mTc-sestamibi study, the CLR increased from 17% (95% CI, 0.10-0.27) for 99mTc-sestamibi imaging to 70% (95% CI, 0.59-0.79) for 18F-fluorocholine PET. Conclusion: In this prospective study using masked readers, the CLR for 18F-fluorocholine PET was 75%. In patients with a paired 99mTc-sestamibi study, the use of 18F-fluorocholine PET increased the CLR from 17% to 70%. 18F-fluorocholine PET is a superior imaging modality for the localization of parathyroid adenomas.
Authors: Michael W Yeh; Hui Zhou; Annette L Adams; Philip H G Ituarte; Ning Li; In-Lu Amy Liu; Philip I Haigh Journal: Ann Intern Med Date: 2016-04-05 Impact factor: 25.391
Authors: Michael A Morris; Babak Saboury; Mark Ahlman; Ashkan A Malayeri; Elizabeth C Jones; Clara C Chen; Corina Millo Journal: Front Endocrinol (Lausanne) Date: 2022-02-25 Impact factor: 5.555