Assessment of the role of early dynamic PET/CT with 18F-fluorocholine in detection of parathyroid lesions in patients with primary hyperparathyroidism

Prabhu, Meghana; Kumari, Garima; Damle, Nishikant; Arora, Geetanjali; Kumar, Praveen; Kumar, Rajeev; Tripathi, Madhavi; Bal, Chandrasekhar; Khadgawat, Rajesh; Kumar, Chitresh; Agarwal, Shipra

doi:10.1097/mnm.0000000000000924

Cited by 20 publications

(22 citation statements)

References 21 publications

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“…Only Rep et al [25] reported scanning patients 3 times, at 5, 60 and 120 min after FCH injection. The FCH dosage was fixed in 16 studies, in the range of 100-230 MBq [15,[19][20][21][22][23][24][25][26][27][28][31][32][33][34]; it was adjusted to the patient's body weight in 5 (1.5-3.2 MBq/kg) and not declared in two studies [12,16,17,29,30].…”

Section: Resultsmentioning

confidence: 99%

“…Comparisons between FCH PET/CT and 99mTc-MIBI SPET/CT with a dual-phase and/or subtraction protocol were reported in numerous studies (Table 2; [4,[12][13][14][15][16][17][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]).…”

Section: Resultsmentioning

confidence: 99%

“…40 min (no activity data) To investigate the performance of FCH PET/MR imaging in patients with HP and non-localized disease who have negative or inconclusive results at US and MIBI scintigraphy US, MIBI SPET/CT FCH PET/MR imaging allowed localization of adenomas with high accuracy when conventional imaging results were inconclusive and provided detailed anatomic information. Prabhu et al [ 15 ] 2018 India 14 P NA PHPT and PTA Dyn. 15 min + Stat.…”

Section: Resultsmentioning

confidence: 99%

“…A careful analysis of the selected literature showed that a dynamic FCH PET/CT protocol was used in 4/23 studies. In particular, Michaud et al [ 13 ] and Kluijhout et al [ 14 ] ran a single dynamic acquisition lasting 10 min and 40 min, respectively; and Michaud et al and Prabhu et al [ 12 , 15 ] performed a dynamic acquisition for 10-15 min followed by a static image 10 or 45 min after the injection. Static acquisitions were obtained in the other studies at a single point ranging from 10 to 60 min after the intravenous administration of FCH in 9/23 studies [ 4 , 16 , 17 , 19 – 23 , 34 ]; and twice, first after 2–60 min and then after 60–120 min, in 10/23 studies.…”

Section: Resultsmentioning

confidence: 99%

“…This aspect does not seem to have been addressed in the literature to date and could be an interesting topic for future research. Only the paper by Prabhu et al [15] reported the time active curves for parathyroid adenoma, thyroid gland and lymph node, demonstrating a higher uptake in parathyroid adenoma in the first 5 min after tracer injection. Michaud et al [13] demonstrated that abnormal foci at a parathyroid gland were visible on early images, although the significant uptake in blood vessels imposed a more careful analysis of the cross-sectional images.…”

Section: Discussionmentioning

confidence: 99%

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18F-choline PET/CT and PET/MRI in primary and recurrent hyperparathyroidism: a systematic review of the literature

et al. 2020

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The aims of the present systematic review were to: (1) assess the role of 18 F-fluorocholine (FCH) positron emission tomography (PET) with computed tomography (CT) and PET with magnetic resonance imaging (MRI) in patients with biochemically known hyperparathyroidism; (2) compare the diagnostic performance of FCH PET/CT or PET/MRI with conventional morphological and functional imaging. A literature search until December 2019 was performed in the PubMed, Scopus and Web of Science databases, using the terms "choline" AND "PET" AND "hyperparathyroidism". The search was conducted with and without the addition of filters (e.g., language: English only; type of article: original article; subjects: humans only) and selecting only articles published in the last 5 years. Twenty-three articles and 1112 patients were considered. Different FCH PET/CT acquisition protocols were adopted across the studies, using dynamic, early or delayed scans. FCH PET/CT proved more accurate than ultrasonography (US) or 99mTc-sestamibi single-photon emission tomography (SPET). PET/ MRI also seemed to be more accurate than MRI alone in detecting benign parathyroid lesions. FCH PET/CT is more accurate than conventional morphological and functional imaging modalities (US or SPET) for the detection of benign parathyroid lesions. It could, therefore, be a reliable tool in both primary and recurrent hyperparathyroidism.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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18F-choline PET/CT and PET/MRI in primary and recurrent hyperparathyroidism: a systematic review of the literature

et al. 2020

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Superior performance of 18F-fluorocholine digital PET/CT in the detection of parathyroid adenomas

López-Mora

Sizova

Estorch

et al. 2020

Eur J Nucl Med Mol Imaging

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Head-to-head comparison of [11C]methionine PET, [11C]choline PET, and 4-dimensional CT as second-line scans for detection of parathyroid adenomas in primary hyperparathyroidism

Noltes,

Kruijff,

Appelman

et al. 2023

Eur J Nucl Med Mol Imaging

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Purpose Accurate preoperative localization is imperative to guide surgery in primary hyperparathyroidism (pHPT). It remains unclear which second-line imaging technique is most effective after negative first-line imaging. In this study, we compare the diagnostic effectiveness of [11C]methionine PET/CT, [11C]choline PET/CT, and four dimensional (4D)-CT head-to-head in patients with pHPT, to explore which of these imaging techniques to use as a second-line scan. Methods We conducted a powered, prospective, blinded cohort study in patients with biochemically proven pHPT and prior negative or discordant first-line imaging consisting of ultrasonography and 99mTc-sestamibi. All patients underwent [11C]methionine PET/CT, [11C]choline PET/CT, and 4D-CT. At first, all scans were interpreted by a nuclear medicine physician, and a radiologist who were blinded from patient data and all imaging results. Next, a non-blinded scan reading was performed. The scan results were correlated with surgical and histopathological findings. Serum calcium values at least 6 months after surgery were used as gold standard for curation of HPT. Results A total of 32 patients were included in the study. With blinded evaluation, [11C]choline PET/CT was positive in 28 patients (88%), [11C]methionine PET/CT in 23 (72%), and 4D-CT in 15 patients (47%), respectively. In total, 30 patients have undergone surgery and 32 parathyroid lesions were histologically confirmed as parathyroid adenomas. Based on the blinded evaluation, lesion-based sensitivity of [11C]choline PET/CT, [11C]methionine PET/CT, and 4D-CT was respectively 85%, 67%, and 39%. The sensitivity of [11C]choline PET/CT differed significantly from that of [11C]methionine PET/CT and 4D-CT (p = 0.031 and p < 0.0005, respectively). Conclusion In the setting of pHPT with negative first-line imaging, [11C]choline PET/CT is superior to [11C]methionine PET/CT and 4D-CT in localizing parathyroid adenomas, allowing correct localization in 85% of adenomas. Further studies are needed to determine cost–benefit and efficacy of these scans, including the timing of these scans as first- or second-line imaging techniques.

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Assessment of the role of early dynamic PET/CT with 18F-fluorocholine in detection of parathyroid lesions in patients with primary hyperparathyroidism

Cited by 20 publications

References 21 publications

18F-choline PET/CT and PET/MRI in primary and recurrent hyperparathyroidism: a systematic review of the literature

18F-choline PET/CT and PET/MRI in primary and recurrent hyperparathyroidism: a systematic review of the literature

Superior performance of 18F-fluorocholine digital PET/CT in the detection of parathyroid adenomas

Head-to-head comparison of [11C]methionine PET, [11C]choline PET, and 4-dimensional CT as second-line scans for detection of parathyroid adenomas in primary hyperparathyroidism

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