Benefit of 18F-fluorocholine PET imaging in parathyroid surgery

Huber, Gerhard; Hüllner, Martin; Schmid, Christoph; Brunner, Andrea; Sah, Bert-Ram; Vetter, Diana; Kaufmann, Philipp A.; Schulthess, Gustav K. von

doi:10.1007/s00330-017-5190-4

Cited by 76 publications

(61 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…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%

See 1 more Smart Citation

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

et al. 2020

View full text Add to dashboard Cite

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.

show abstract

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%

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

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Nuclear medicine option with superior spatial resolution and sensitivity is 18 F-Fluorocholine PET/CT. 18 F-Fluorocholine (FCH) is marker of cell membrane turnover (19). Sensitivity of 94%, specificity 96%, PPV 90.2%, NPV 97.4% and diagnostic accuracy 95.3% were achieved using this tracer, making it the most promising tracer with high diagnostic performance (10,20).…”

Section: Discussionmentioning

confidence: 99%

Dual Tracer 99mTc-Pertechnetate/99mTc-MIBI Dual-Time-Point SPECT/CT Parathyroid Gland Assessment Regarding to Parathyroid Gland Size and Biochemical Parameters – Two Years Single Imaging Centre Experience

Krčálová

Horáček

Nováková³

et al. 2019

Acta Med. (Hradec Kralove, Czech Repub.)

View full text Add to dashboard Cite

Introduction: Preoperative parathyroid imaging is inevitable part of focused parathyroid surgery. The aim of our study was assessment of parathyroid scintigraphy diagnostic accuracy regarding to size and metabolic parameters of hyperfunctioning parathyroid tissue. Material and methods: Parathyroid scintigraphy for suspected primary hyperparathyroidism was performed in 95 patients during years 2015 and 2016. Of them, 75 patients with known clinical outcome (40 underwent surgery, 35 had documented laboratory follow-up) were further retrospectively evaluated. The performance of dual tracer 99mTc-pertechnetate and 99mTc-MIBI subtraction and dual-time-point 99mTc-MIBI imaging with SPECT/CT was analysed. Serum parathyroid hormone (PTH), calcaemia, ionized calcaemia and phosphataemia and ultrasound detected adenoma volume and largest diameter in false negative and true positive findings were compared using Mann-Whitney test. Results: Sensitivity and specificity of parathyroid scintigraphy was 74.5% and 95.8%, respectively. NPV was 63.8% and PPV 97.4%. Hyperfunctioning parathyroid tissue detectability was almost significantly associated with hypophosphataemia and PTH levels. Conclusion: Parathyroid scintigraphy provides high sensitivity and superior specificity in parathyroid adenoma location, nevertheless the diagnostic accuracy tends to decline in smaller adenomas and in less metabolically active parathyroid tissue causing only subtle biochemical changes. 18F-Fluorocholine PET/CT or 3D SPECT/CT subtraction should be a reasonable option for those cases.

show abstract

“…Following incidental detection of FCH uptake in parathyroid adenoma, several clinical studies have been published on the role of FCH PET/CT in hyperparathyroidism, and they have shown better diagnostic performance of FCH PET/CT in comparison with other conventional imaging methods, with higher sensitivity and equally high specificity (7)(8)(9)(10)(11)(12)(14)(15)(16)(17). A recent meta-analysis evaluating the diagnostic performance of FCH PET/CT in hyperparathyroidism revealed that the sensitivity and specificity of FCH PET/CT were 90% and 94%, respectively (18), and another study also reported excellent sensitivity, PPV, and detection rate of 95%, 97%, and 91%, respectively (19).…”

Section: Discussionmentioning

confidence: 99%

Performance of F-18 Fluorocholine PET/CT for Detection of Hyperfunctioning Parathyroid Tissue in Patients with Elevated Parathyroid Hormone Levels and Negative or Discrepant Results in conventional Imaging

et al. 2020

View full text Add to dashboard Cite

Objective: Our aim was to assess the diagnostic performance of F-18 fluorocholine (FCH) positron emission tomography/ computed tomography (PET/CT) in detecting hyperfunctioning parathyroid tissue (HPT) in patients with elevated parathyroid hormone levels with negative or inconclusive conventional imaging results and to compare the findings with those obtained using technetium-99m sestamibi (MIBI) scintigraphy and neck ultrasonography (US). Materials and Methods: Images of 105 patients with hyperparathyroidism who underwent FCH PET/CT, dual-phase MIBI parathyroid scintigraphy (median interval: 42 days), and neck US were retrospectively analyzed. The gold standard was histopathological findings for 81 patients who underwent parathyroidectomy and clinical follow-up findings in the remaining 24 patients. Sensitivities, positive predictive values (PPVs), and accuracies were calculated for all imaging modalities. Results: Among the 81 patients who underwent parathyroidectomy, either parathyroid adenoma (n = 64), hyperplasia (n = 9), neoplasia (n = 4), or both parathyroid adenoma and hyperplasia (n = 1) were detected, except 3 patients who did not show HPT. Of the 24 (23%) patients who were followed-up without operation, 22 (92%) showed persistent hyperparathyroidism. FCH PET/CT showed significantly higher sensitivity than MIBI scintigraphy and US in detection of HPT (p < 0.01). Sensitivity, PPV, and accuracy of FCH PET/CT were 94.1% (95/101), 97.9% (95/97), and 92.4% (97/105), respectively. The corresponding values for MIBI scintigraphy and US were 45.1% (46/102), 97.9% (46/47), and 45.7% (48/105) and 44.1% (45/102), 93.8% (45/48), and 42.9% (45/105), respectively. Among the 35 patients showing negative MIBI scintigraphy and neck US findings, 30 (86%) showed positive results on FCH PET/CT. FCH PET/CT could demonstrate ectopic locations of HPT in 11 patients whereas MIBI and US showed positive findings in only 6 and 3 patients, respectively. Conclusion: FCH PET/CT is an effective imaging modality for detection of HPT with the highest sensitivity among the available imaging techniques. Therefore, FCH PET/CT can be recommended especially for patients who show negative or inconclusive results on conventional imaging.

show abstract

Benefit of 18F-fluorocholine PET imaging in parathyroid surgery

Abstract: • With F-fluorocholine PET imaging, parathyroid adenomas could be detected in 96.2%. • F-fluorocholine imaging is a highly accurate method to detect parathyroid adenomas. • We encourage its use, where ultrasound fails to detect an adenoma.

Cited by 76 publications

References 27 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

Dual Tracer 99mTc-Pertechnetate/99mTc-MIBI Dual-Time-Point SPECT/CT Parathyroid Gland Assessment Regarding to Parathyroid Gland Size and Biochemical Parameters – Two Years Single Imaging Centre Experience

Performance of F-18 Fluorocholine PET/CT for Detection of Hyperfunctioning Parathyroid Tissue in Patients with Elevated Parathyroid Hormone Levels and Negative or Discrepant Results in conventional Imaging

Contact Info

Product

Resources

About