Bewegungsadaptierte Schwächungskorrektur mit Averaging-CT und 4D-CT im 4D PET-CT der Lunge

Background: The diagnostic performance of [18F]fluoro-ethylcholine-PET-CT&4D-CT (FEC-PET&4D-CT) to identify parathyroid adenomas (PA) was analyzed when ultrasound (US) or MIBI-Scan (MS) failed to localize. Postsurgical one year follow-up data are presented. Methods: Patients in whom US and MS delivered either incongruent or entirely negative findings were subjected to FEC-PET&4D-CT and cases from July 2017 to June 2020 were analyzed, retrospectively. Cervical exploration with intraoperative PTH-monitoring (IO-PTH) was performed. Imaging results were correlated to intraoperative findings, and short term and one year postoperative follow-up data. Results: From July 2017 to June 2020 in 171 FEC-PET&4D-CTs 159 (92.9%) PAs were suggested. 147 patients already had surgery, FEC-PET&4D-CT accurately localized in 141; false neg. 4, false pos. 2, global sensitivity 0.97; accuracy 0.96, PPV 0.99. All of the 117 patients that already have completed their 12-month postoperative follow up had normal biochemical parameter, i.e., no signs of persisting disease. However, two cases may have a potential for recurrent disease, for a cure rate of at least 98.3%. Conclusion: FEC-PET&4D-CT shows unprecedented results regarding the accuracy localizing PAs. The one-year-follow-up data demonstrate a high cure rate. We, therefore, suggest FEC-PET-CT as the relevant diagnostic tool for the localization of PAs when US fails to localize PA, especially after previous surgery to the neck.

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18F-Fluorocholine PET and 4D-CT in Patients with Persistent and Recurrent Primary Hyperparathyroidism

Diagnostics ◽

10.3390/diagnostics11122384 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2384

Author(s):

Adrien Latge ◽

Sophie Riehm ◽

Michel Vix ◽

Jacob Bani ◽

Mihaela Ignat ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Detection Rate ◽

Parathyroid Tissue ◽

Dynamic Ct ◽

Surgical Guidance ◽

4D Ct ◽

Surgical Success ◽

Pet Ct ◽

Higher Sensitivity ◽

Better Than

Patients with primary hyperparathyroidism (pHPT) can develop persistent (P-pHPT) or recurrent (R-pHPT) disease after parathyroidectomy. Before recommending reoperation, recurrence must be accurately identified because of the high risk of complications. Our study evaluates 18F-fluorocholine (18F-FCH) PET/CT and 4D-CT integrated in PET/4D-CT in patients with P-pHPT/R-pHPT. Patients with P-pHPT/R-pHPT investigated by 18F-FCH PET/4D-CT between May 2018 and March 2021 were retrospectively included. Forty-two patients were included, 37 of whom underwent 4D-CT. The sensitivity and detection rate (DR%) were 95% and 88% for 18F-FCH PET/CT and 70% and 63% for 4D-CT, respectively. PET/CT and 4D-CT were concordant in 18/24 glands and concordant and positive in 15/24 (63%) glands. Discordant results were obtained for 6/24 glands. The surgical success rate was 65%. PET/CT showed significantly higher sensitivity than 4D-CT. Dynamic CT allowed the identification of no additional glands missed by PET/CT, and the combination of the 2 techniques did not improve the sensitivity or DR%. 18F-FCH PET/CT appears to be a valuable technique to accurately detect hyperfunctioning parathyroid tissue in patients with P-pHPT/R-pHPT and is better than 4D-CT. Except for cases with doubtful locations of PET targets that may require 4D-CT for surgical guidance, standard nonenhanced 18F-FCH PET/CT can be effectively recommended in patients with P-pHPT/R-pHPT before reoperation.

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18F-Fluorocholine PET and Multiphase CT Integrated in Dual Modality PET/4D-CT for Preoperative Evaluation of Primary Hyperparathyroidism

Journal of Clinical Medicine ◽

10.3390/jcm9062005 ◽

2020 ◽

Vol 9 (6) ◽

pp. 2005

Author(s):

Valentin Pretet ◽

Marianela Rotania ◽

Mehdi Helali ◽

Mihaela Ignat ◽

Michel Vix ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Preoperative Evaluation ◽

High Serum ◽

Additional Patient ◽

Second Line ◽

4D Ct ◽

Pet Ct ◽

Line Imaging ◽

Preoperative Work Up ◽

Work Up

The present retrospective study evaluates the diagnostic value of integrated 18F-Fluorocholine positron emission tomography/four-dimensional contrast-enhanced computed tomography (18F-FCH PET/4D-CT) as second-line imaging in preoperative work-up of primary hyperparathyroidism (pHPT), and compares 18F-FCH PET with 4D-CT. Patients with pHPT and negative/discordant first-line imaging addressed for integrated 18F-FCH PET/4D-CT were retrospectively selected. Sensitivity and detection rate (DR%) of 18F-FCH PET/CT, 4D-CT, and PET/4D-CT were calculated according to the per patient and per lesion analyses, and afterwards compared. Histology associated with a decrease more than 50% of perioperative parathyroid hormone (PTH) blood level was used as a gold standard. Persistent high serum PTH and calcium levels during a 6-month follow-up was considered as presence of pHPT in both operated and non-operated patients. 50 patients (55 glands) were included. 44/50 patients (88%) were surgically treated. On a per patient analysis, sensitivity was 93%, 80%, and 95%, and DR% was 82%, 68%, and 84%, respectively for PET/CT, 4D-CT, and PET/4D-CT. PET/CT was more sensitive than 4D-CT (p = 0.046). PET/4D-CT performed better than 4D-CT (p = 0.013) but was equivalent to PET/CT alone. On a per gland analysis, sensitivity PET/CT, 4D-CT, and PET/4D-CT was 88%, 66%, and 92%, and DR% was 79%, 57%, and 83%, respectively. PET/CT and PET/4D-CT were more sensitive than 4D-CT alone (p = 0.01, p < 0.001, respectively). However, PET/CT and PET/4D-CT performed similarly. In conclusion, 18F-FCH PET provides better identification of hyperfunctioning parathyroids than 4D-CT and the combination of both did not significantly improve diagnostic sensitivity. Further investigations involving larger populations are necessary to define the role of 18F-FCH PET/4D-CT as a “one-stop shop” second-line imaging in preoperative work-up of pHPT, especially considering the additional patient radiation exposure due to multi-phase CT.

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1596: Lymph Node Staging in Prostate Cancer by the use of 11C-CHOLIN-PET/CT Scan Imaging

The Journal of Urology ◽

10.1016/s0022-5347(18)35718-5 ◽

2005 ◽

Vol 173 (4S) ◽

pp. 432-432

Author(s):

Georg C. Bartsch ◽

Norbert Blumstein ◽

Ludwig J. Rinnab ◽

Richard E. Hautmann ◽

Peter M. Messer ◽

...

Keyword(s):

Prostate Cancer ◽

Lymph Node ◽

Ct Scan ◽

Lymph Node Staging ◽

Pet Ct ◽

Pet Ct Scan

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Diese unglaubliche Müdigkeit und immer wieder abends Fieber und Kopfschmerzen

Praxis ◽

10.1024/1661-8157/a002777 ◽

2017 ◽

Vol 106 (19) ◽

pp. 1061-1064

Author(s):

Katharina Brodsky ◽

Dominique Oberlin ◽

Reto Nüesch

Keyword(s):

Sich Eine ◽

Pet Ct

Zusammenfassung. Wir berichten über einen 58-jährigen Patienten mit seit Monaten bestehender B-Symptomatik, rezidivierenden Fieberschüben begleitet von Kopfschmerzen und erhöhten Entzündungsparametern. In der Erstlinienabklärung ergaben sich keine eindeutigen Hinweise auf eine infektiologische oder rheumatologische Ursache, auffällig war lediglich eine mediastinale und hiläre Lymphadenopathie. Zum Ausschluss eines Malignoms wurde eine PET-CT durchgeführt, in der sich eine FDG-Aufnahme im Bereich der grossen Gefässe zeigte, passend zu einer Riesenzellarteritis. Bei eindeutigem Befund konnte auf einen Temporalarterienbiopsie verzichtet und eine Therapie mit Glukokortikoiden begonnen werden.

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