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A retrospective analysis of the diagnostic performance of (11)C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism

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 (11)C-choline PET/CT in patients with pHPT as a next in-line scan after...

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Autores principales: Noltes, M. E., Kruijff, S., Jansen, L., Westerlaan, H. E., Zandee, W. T., Dierckx, R. A. J. O., Brouwers, A. H.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997941/
https://www.ncbi.nlm.nih.gov/pubmed/33770255
http://dx.doi.org/10.1186/s13550-021-00778-7
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author Noltes, M. E.
Kruijff, S.
Jansen, L.
Westerlaan, H. E.
Zandee, W. T.
Dierckx, R. A. J. O.
Brouwers, A. H.
author_facet Noltes, M. E.
Kruijff, S.
Jansen, L.
Westerlaan, H. E.
Zandee, W. T.
Dierckx, R. A. J. O.
Brouwers, A. H.
author_sort Noltes, M. E.
collection PubMed
description 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 (11)C-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 (11)C-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 (11)C-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 (11)C-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 (11)C-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 (11)C-choline PET/CT with high sensitivity and accuracy.
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spelling pubmed-79979412021-04-16 A retrospective analysis of the diagnostic performance of (11)C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism Noltes, M. E. Kruijff, S. Jansen, L. Westerlaan, H. E. Zandee, W. T. Dierckx, R. A. J. O. Brouwers, A. H. EJNMMI Res Original Research 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 (11)C-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 (11)C-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 (11)C-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 (11)C-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 (11)C-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 (11)C-choline PET/CT with high sensitivity and accuracy. Springer Berlin Heidelberg 2021-03-26 /pmc/articles/PMC7997941/ /pubmed/33770255 http://dx.doi.org/10.1186/s13550-021-00778-7 Text en © The Author(s) 2021 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Noltes, M. E.
Kruijff, S.
Jansen, L.
Westerlaan, H. E.
Zandee, W. T.
Dierckx, R. A. J. O.
Brouwers, A. H.
A retrospective analysis of the diagnostic performance of (11)C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism
title A retrospective analysis of the diagnostic performance of (11)C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism
title_full A retrospective analysis of the diagnostic performance of (11)C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism
title_fullStr A retrospective analysis of the diagnostic performance of (11)C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism
title_full_unstemmed A retrospective analysis of the diagnostic performance of (11)C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism
title_short A retrospective analysis of the diagnostic performance of (11)C-choline PET/CT for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism
title_sort retrospective analysis of the diagnostic performance of (11)c-choline pet/ct for detection of hyperfunctioning parathyroid glands after prior negative or discordant imaging in primary hyperparathyroidism
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7997941/
https://www.ncbi.nlm.nih.gov/pubmed/33770255
http://dx.doi.org/10.1186/s13550-021-00778-7
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