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

Diagnostics ◽  
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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