scholarly journals 11C-Choline PET/CT vs. 99mTc-MIBI/123Iodide Subtraction SPECT/CT for Preoperative Detection of Abnormal Parathyroid Glands in Primary Hyperparathyroidism: A Prospective, Single-Centre Clinical Trial in 60 Patients

Diagnostics ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. 975
Author(s):  
Afefah Ismail ◽  
Julie Wulf Christensen ◽  
Martin Krakauer ◽  
Susanne Bonnichsen Søndergaard ◽  
Bo Zerahn ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Method Comparison ◽  
Preoperative Imaging ◽  
P Value ◽  
Imaging Method ◽  
Dual Isotope ◽  
Choline Pet ◽  
First Choice ◽  
Pet Ct ◽  
99Mtc Mibi

Background: In patients with primary hyperparathyroidism (PHPT) locating hyperfunctioning glands (HPGs) is crucial when planning minimally invasive surgery. Dual-isotope subtraction scintigraphy with 99mTc-MIBI/123Iodide using SPECT/CT and planar pinhole imaging (Method A) has previously shown a sensitivity >93%. However, the method is costly and time consuming and entails a high radiation dose. 11C-Choline PET/CT (Method B) is an appealing candidate method unencumbered by these disadvantages. Methods: Sixty patients with newly diagnosed PHPT participated and were scanned using both methods prior to parathyroidectomy. We investigated whether sensitivities of Method A and Method B are similar in a method-to-method comparison when using surgical findings as the true location. Results: At the patient level, sensitivities were (A) 0.98 (95% CI: 0.90–1.00) and (B) 1.00 (95% CI: 0.93–1.00). At the gland level, sensitivities were (A) 0.88 (95% CI: 0.78–0.94) and (B) 0.87 (95% CI: 0.76–0.92). With a non-inferiority margin of ∆ = −0.1, we found a 1-sided p-value < 0.001. Conclusion: Our methods comparison study found that sensitivity of Method B was not inferior to Method A. We suggest that 11C-Choline PET/CT is a clinically relevant first-choice candidate for preoperative imaging of PHPT and that Method B can likely replace Method A in the near future.

scholarly journals Predictors of adenoma size and location in primary hyperparathyroidism

2021 ◽  
Author(s):  
Barbara Filser ◽  
Verena Uslar ◽  
Dirk Weyhe ◽  
Navid Tabriz
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Biochemical Markers ◽  
Laboratory Data ◽  
Thyroid Volume ◽  
Preoperative Imaging ◽  
Imaging Method ◽  
Imaging Results ◽  
First Choice ◽  
Multivariable Regression

Abstract Purpose In primary hyperparathyroidism (PHPT), intraoperative localization of the parathyroid adenoma can be challenging, especially in cases of negative preoperative imaging. Since a focused unilateral parathyroidectomy has benefits compared to a conventional bilateral neck exploration, the question arises whether adenoma size prediction can facilitate a targeted approach. We investigated whether single parathyroid adenoma size can be estimated using preoperative parathyroid hormone (PTH), calcium, and phosphate in patients with PHPT. Preoperative imaging accuracy was evaluated. Methods The data of 156 patients who underwent curative parathyroidectomy for single adenoma PHPT were analyzed retrospectively. Information obtained included laboratory data, imaging results, intraoperative data, and final pathology. Imaging accuracy was analyzed descriptively. The association between preoperative biochemical markers and adenoma dimensions was investigated using Spearman’s correlation coefficient and multivariable regression modeling. Results Cervical ultrasound correctly predicted adenoma laterality in 95.5%, sestamibi scintigraphy in 80.6%, both had lower true-positive rates for quadrant prediction. Patients with negative imaging results showed higher thyroid volumes than those with positive results. Adenoma volume was positively correlated with preoperative PTH (p < 0.001) and calcium (p < 0.001) and negatively correlated with preoperative phosphate (p = 0.001). Using these preoperative biochemical markers and patient age and BMI, adenoma volume can be significantly predicted using the multivariable regression algorithm. Conclusion Cervical ultrasound is superior to scintigraphy for predicting adenoma location and should be the first-choice imaging method, but both methods may be limited by increased thyroid volume. Large adenomas are more likely with higher PTH, higher calcium, and lower phosphate levels. In cases of undetermined adenoma location, an estimation of adenoma volume via our algorithm could corroborate sonographic volume measurements of the suspected adenoma.

18Fluoro-choline PET/CT is a useful tool for patients with primary hyperparathyroidism negative at first-line imaging localization tecniques

2020 ◽  
Author(s):  
Matteo Apicella ◽  
Stefano Bola ◽  
Duccio Volterrani ◽  
Laura Mazoni ◽  
Gianluca Frustaci ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
First Line ◽  
Choline Pet ◽  
Pet Ct ◽  
Line Imaging

18F-Choline PET/CT, MRI, and Software-Based Image Fusion Analysis in Patients With Primary Hyperparathyroidism

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Thomas Hofer ◽  
Juergen Kronbichler ◽  
Helmut Huber ◽  
Benedikt Hergan ◽  
Bernhard Kaiser ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Image Fusion ◽  
Choline Pet ◽  
Pet Ct ◽  
Fusion Analysis

scholarly journals F18-choline PET/CT guided surgery in primary hyperparathyroidism when ultrasound and MIBI SPECT/CT are negative or inconclusive: the APACH1 study

2017 ◽  
Vol 45 (4) ◽  
pp. 658-666 ◽  
Author(s):  
Elske Quak ◽  
David Blanchard ◽  
Benjamin Houdu ◽  
Yannick Le Roux ◽  
Renaud Ciappuccini ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Ct Guided ◽  
Guided Surgery ◽  
Choline Pet ◽  
Pet Ct ◽  
Mibi Spect

scholarly journals Added Value of Subtraction SPECT/CT in Dual-Isotope Parathyroid Scintigraphy

Diagnostics ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. 639 ◽  
Author(s):  
Julie Wulf Christensen ◽  
Martin Krakauer
Keyword(s):  
Computed Tomography ◽  
Primary Hyperparathyroidism ◽  
Added Value ◽  
Dual Method ◽  
Preoperative Imaging ◽  
Emission Computed Tomography ◽  
Parathyroid Scintigraphy ◽  
Dual Isotope ◽  
Single Method ◽  
Subtraction Scintigraphy

Background: Adding subtraction single-photon emission computed tomography/computed tomography (SPECT/CT) to dual isotope (I-123 and Tc-99m-sestamibi) subtraction parathyroid scintigraphy is not widely implemented. We aimed to assess the added value of dual isotope subtraction SPECT/CT over single isotope SPECT/CT as an adjunct to dual isotope planar pinhole subtraction scintigraphy. Methods: Parathyroid scintigraphies from 106 patients with an estimated total of 415 parathyroid glands who (1) were diagnosed with primary hyperparathyroidism, (2) underwent dual isotope subtraction scintigraphy in the Department of Nuclear Medicine, Gentofte Hospital, Denmark throughout 2017 and (3) underwent subsequent parathyroidectomy, were included. The original dual isotope planar pinhole subtraction plus dual isotope subtraction SPECT/CT (dual/dual method) exams were retrospectively re-evaluated using only Tc-99m-sestamibi SPECT/CT (dual/single method). Statistics were calculated per parathyroid. Surgical results confirmed by pathology served as reference standard. Results: The dual/dual method had higher sensitivity than the dual/single method (82% (95%CI 74%–88%) vs. 69% (95%CI 60%–77%)) while specificity, positive and negative predictive values (PPV and NPV) were similar (specificity 96% vs. 93%, PPV’s 87% vs. 82% and NPV’s 89% vs. 93%). Reader confidence was higher when employing the dual/dual method (p = 0.001). Conclusions: The dual/dual method can be considered superior to the dual/single method in the preoperative imaging in primary hyperparathyroidism.

Dual-Isotope 99mTc-MIBI/123I Parathyroid Scintigraphy in Primary Hyperparathyroidism

2014 ◽  
Vol 39 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Stéphanie Hassler ◽  
Dorra Ben-Sellem ◽  
Fabrice Hubele ◽  
Andre Constantinesco ◽  
Christian Goetz
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Scintigraphy ◽  
Dual Isotope ◽  
99Mtc Mibi
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