PT - JOURNAL ARTICLE AU - Julia Whitman AU - Isabel E. Allen AU - Emily K. Bergsland AU - Insoo Suh AU - Thomas A. Hope TI - Assessment and Comparison of <sup>18</sup>F-Fluorocholine PET and <sup>99m</sup>Tc-Sestamibi Scans in Identifying Parathyroid Adenomas: A Metaanalysis AID - 10.2967/jnumed.120.257303 DP - 2021 Sep 01 TA - Journal of Nuclear Medicine PG - 1285--1291 VI - 62 IP - 9 4099 - http://jnm.snmjournals.org/content/62/9/1285.short 4100 - http://jnm.snmjournals.org/content/62/9/1285.full SO - J Nucl Med2021 Sep 01; 62 AB - Hyperparathyroidism is an endocrine disorder caused by one or more hyperfunctioning parathyroid glands. Current imaging consisting of ultrasound and 99mTc-sestamibi is imprecise, making localization difficult. 18F-fluorocholine (18F-FCH) PET has recently shown promise in presurgical localization of parathyroid adenomas. The primary aim of this study was to summarize the sensitivities and specificities of studies using 18F-FCH PET to localize hyperparathyroidism. A secondary aim was to summarize a subset of studies in which 99mTc-sestamibi scans were also used and to compare the performance of the 2 modalities. Methods: We searched the MEDLINE and EMBASE databases following the PRISMA (Preferred Reporting Items for Systematic Review and Metaanalysis) statement. Quality was assessed using the QUADAS-2 tool (Quality Assessment of Diagnostic Accuracy Studies). Twenty studies were included for quantitative assessment in our metaanalysis. A random-effects model and a hierarchic summary receiver-operating-characteristic model was used to summarize the sensitivity of 18F-FCH PET in detecting abnormal parathyroid adenomas. We used the same methodology to assess sensitivity of 99mTc-sestamibi, as a comparison to 18F-FCH PET. Results: 18F-FCH PET had a high sensitivity, 0.97 (range, 0.96–0.98), for the detection of abnormal parathyroid adenomas. In the subpopulation for which both 18F-FCH and 99mTc-sestamibi were reported, 18F-FCH also had a higher sensitivity, 0.96 (0.94–0.98), than the 0.54 (0.29–0.79) reported for 99mTc-sestamibi (P &lt; 0.001). Conclusion: 18F-FCH PET demonstrates high localization accuracy in patients with hyperparathyroidism. This metaanalysis supports the use of 18F-FCH over 99mTc-sestamibi in patients with hyperparathyroidism.