M E Noltes1,2, S Kruijff1,2, L Jansen2, H E Westerlaan3, W T Zandee4, R A J O Dierckx1, A H Brouwers5. 1. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. 2. Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 3. Department of Radiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 4. Department of Internal Medicine, Division of Endocrinology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. 5. Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. a.h.brouwers@umcg.nl.
Abstract
BACKGROUND: Identifying the correct location of a parathyroid adenoma in patients with primary hyperparathyroidism (pHPT) is crucial as it can guide surgical treatment. This study aimed to determine the diagnostic performance of 11C-choline PET/CT in patients with pHPT as a next in-line scan after primary negative or discordant first-line imaging. METHODS: This was a retrospective single-center cohort study. All patients with pHPT that were scanned utilizing 11C-choline PET/CT, after prior negative or discordant imaging, between 2015 and 2019 and who subsequently underwent parathyroid surgery were included. The results of the 11C-choline PET/CT were evaluated lesion-based, with surgical exploration and histopathological examination as the gold standard. RESULTS: In total, 36 patients were included of which three patients were known to have Multiple Endocrine Neoplasia (MEN) syndrome. In these 36 patients, 40 lesions were identified on 11C-choline PET/CT and 37 parathyroid lesions were surgically removed. In 34/36 (94%) patients a focused parathyroidectomy was performed, in one patient a cervical exploration due to an ectopically identified adenoma, and in one patient a bilateral exploration was performed because of a double adenoma. Overall, per-lesion sensitivity of 11C-choline PET/CT was 97%, the positive predictive value was 95% and the accuracy was 94% for all parathyroid lesions. CONCLUSIONS: In patients with pHPT and prior negative or discordant first-line imaging results, pathological parathyroid glands can be localized by 11C-choline PET/CT with high sensitivity and accuracy.
BACKGROUND: Identifying the correct location of a parathyroid adenoma in patients with primary hyperparathyroidism (pHPT) is crucial as it can guide surgical treatment. This study aimed to determine the diagnostic performance of 11C-choline PET/CT in patients with pHPT as a next in-line scan after primary negative or discordant first-line imaging. METHODS: This was a retrospective single-center cohort study. All patients with pHPT that were scanned utilizing 11C-choline PET/CT, after prior negative or discordant imaging, between 2015 and 2019 and who subsequently underwent parathyroid surgery were included. The results of the 11C-choline PET/CT were evaluated lesion-based, with surgical exploration and histopathological examination as the gold standard. RESULTS: In total, 36 patients were included of which three patients were known to have Multiple Endocrine Neoplasia (MEN) syndrome. In these 36 patients, 40 lesions were identified on 11C-choline PET/CT and 37 parathyroid lesions were surgically removed. In 34/36 (94%) patients a focused parathyroidectomy was performed, in one patient a cervical exploration due to an ectopically identified adenoma, and in one patient a bilateral exploration was performed because of a double adenoma. Overall, per-lesion sensitivity of 11C-choline PET/CT was 97%, the positive predictive value was 95% and the accuracy was 94% for all parathyroid lesions. CONCLUSIONS: In patients with pHPT and prior negative or discordant first-line imaging results, pathological parathyroid glands can be localized by 11C-choline PET/CT with high sensitivity and accuracy.
Authors: Giorgio Treglia; Arnoldo Piccardo; Alessio Imperiale; Klaus Strobel; Philipp A Kaufmann; John O Prior; Luca Giovanella Journal: Eur J Nucl Med Mol Imaging Date: 2018-08-09 Impact factor: 9.236
Authors: I Bossert; S Chytiris; M Hodolic; L Croce; L Mansi; L Chiovato; G Mariani; G Trifirò Journal: J Endocrinol Invest Date: 2018-08-09 Impact factor: 4.256
Authors: Scott M Wilhelm; Tracy S Wang; Daniel T Ruan; James A Lee; Sylvia L Asa; Quan-Yang Duh; Gerard M Doherty; Miguel F Herrera; Janice L Pasieka; Nancy D Perrier; Shonni J Silverberg; Carmen C Solórzano; Cord Sturgeon; Mitchell E Tublin; Robert Udelsman; Sally E Carty Journal: JAMA Surg Date: 2016-10-01 Impact factor: 14.766
Authors: Milou E Noltes; Stephan Brands; Rudi A J O Dierckx; Pieter L Jager; Wendy Kelder; Adrienne H Brouwers; Anne Brecht Francken; Schelto Kruijff Journal: Laryngoscope Investig Otolaryngol Date: 2020-10-08
Authors: Julie W Christensen; Afefah Ismail; Susanne B Søndergaard; Finn N Bennedbaek; Birte Nygaard; Lars T Jensen; Waldemar Trolle; Christoffer Holst-Hahn; Bo Zerahn; Bent Kristensen; Martin Krakauer Journal: Clin Endocrinol (Oxf) Date: 2022-02-21 Impact factor: 3.523