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

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.

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

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

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
M. E. Noltes ◽  
S. Kruijff ◽  
L. Jansen ◽  
H. E. Westerlaan ◽  
W. T. Zandee ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Diagnostic Performance ◽  
Histopathological Examination ◽  
Parathyroid Glands ◽  
First Line ◽  
Choline Pet ◽  
Imaging Results ◽  
Pet Ct ◽  
Parathyroid Lesions ◽  
Line Imaging

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.

The Added Diagnostic Value of 18F-Fluorodihydroxyphenylalanine PET/CT in the Preoperative Work-Up of Small Bowel Neuroendocrine Tumors

2017 ◽  
Vol 22 (4) ◽  
pp. 722-730 ◽  
Author(s):  
Pietro Addeo ◽  
Gilles Poncet ◽  
Bernard Goichot ◽  
Loic Leclerc ◽  
Cécile Brigand ◽  
...  
Keyword(s):  
Small Bowel ◽  
Neuroendocrine Tumors ◽  
Diagnostic Value ◽  
Pet Ct ◽  
Preoperative Work Up ◽  
Work Up

Preoperative Work-up: PET and PET-CT

2012 ◽  
pp. 57-62
Author(s):  
Valentina Ambrosini ◽  
Maria Cristina Marzola ◽  
Paola Caroli ◽  
Stefano Fanti ◽  
Domenico Rubello
Keyword(s):  
Pet Ct ◽  
Preoperative Work Up ◽  
Work Up

scholarly journals Location of Parathyroid Adenomas in Primary Hyperparathyroidism: Where to look?

2015 ◽  
Vol 7 (1) ◽  
pp. 1-5
Author(s):  
Mehmet Uludag ◽  
Pinar Yazici ◽  
Mehmet Mihmanli ◽  
Emre Bozdag ◽  
Nurcihan Aygun
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Minimal Invasive ◽  
Parathyroid Surgery ◽  
Postoperative Hypocalcemia ◽  
Chi Square ◽  
Parathyroid Adenomas ◽  
Operative Notes ◽  
Preoperative Work Up ◽  
Work Up

ABSTRACT Purpose Preoperative localization studies for parathyroid adenomas are very essential to perform minimal invasive parathyroidectomy (MIP) with decreased operative time and potential complications. Although most of these studies based on radiological imaging, intraoperative assessment provides the most accurate anatomical description of the location of parathyroid adenomas. In this study, we aim to evaluate the surgical variations of locations of parathyroid adenomas in patients performed parathyroid surgery for primary hyperparathyroidism (PHPT). Materials and methods Between January 2010 and December 2013, 243 patients (201 women/42 men) who underwent parathyroid surgery due to phPT were included. A total of 254 parathyroid adenomas were detected. Demographic features, preoperative work-up, surgical approach, types of procedures and postoperative complications were noted. Locations of parathyroid adenomas were recorded from operative notes. Statistical analysis was performed using t-test and chi-square. continuous data are expressed as mean ± standard deviation. Results With regard to the most frequently observed, location of adenomas were as follows; right inferior (n = 89, 37.7%), left inferior (n = 78, 33%), right superior (n = 44, 18.6%), left superior (n = 25, 10.5%) and ectopic locations (n = 18). Ectopic adenomas were mostly located in the thymus (n = 9) and intrathyroidal tissue (n = 6) at a rate of 83%. Postoperative hypocalcemia (11%) was mostly seen in those with parathyroid adenoma located around the inferior lobes of the thyroid (86%) and undergoing bilateral neck exploration (75%). Conclusion The most of the parathyroid adenomas were found in orthotopic position and located around the lower pole of the thyroid gland. Ectopic adenomas were mostly located in thymus or intrathyroidal. Postoperative hypocalcemia was also higher in those with parathyroid adenoma located around the inferior lobe of the thyroid. How to cite this article Yazici P, Mihmanli M, Bozdag E, Aygun N, Uludag M. Location of Parathyroid Adenomas in Primary Hyperparathyroidism: Where to look? World J Endoc Surg 2015;7(1):1-5.

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