RT Journal Article
SR Electronic
T1 Preoperative Localization of Adenomas in Primary Hyperparathyroidism: The Value of <sup>11</sup>C-Choline PET/CT in Patients with Negative or Discordant Findings on Ultrasonography and <sup>99m</sup>Tc-Sestamibi SPECT/CT
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 584
OP 589
DO 10.2967/jnumed.119.233213
VO 61
IS 4
A1 Yimin Liu
A1 Yonghong Dang
A1 Li Huo
A1 Ya Hu
A1 Ou Wang
A1 He Liu
A1 Xiaoyan Chang
A1 Yu Liu
A1 Xiaoping Xing
A1 Fang Li
A1 Quan Liao
A1 Marcus Hacker
A1 Xiang Li
A1 Michael C. Kreissl
YR 2020
UL http://jnm.snmjournals.org/content/61/4/584.abstract
AB We aimed to assess the value of 11C-choline PET in patients with primary hyperparathyroidism and negative or discordant results on 99mTc-sestamibi imaging and neck ultrasound. Methods: Eighty-seven such patients were assessed and subsequently underwent parathyroidectomy. PET/CT image data were analyzed semiquantitatively using SUVmax and SUV ratios (target to contralateral thyroid gland and carotid artery). A positive PET/CT result was defined as focal uptake significantly higher than regular thyroid tissue. Ectopic foci were also considered positive. Inconclusive PET/CT cases were defined as a lesion with uptake equal to normal thyroid tissue. If no prominent or ectopic uptake was detectable, the PET/CT result was considered negative. Results: When dichotomizing the 11C-choline PET/CT imaging results by defining lesions with both positive and inconclusive uptake as positive, we found 84 of 92 lesions (91.3%) to have true-positive uptake whereas 8 lesions (8.7%) had false-positive uptake. One lesion showed false-negative uptake; the sensitivity was 98.8%. The corresponding positive predictive value for lesions was 91.3%. The mean SUVmax was 6.15 ± 4.92 in 72 lesions with positive uptake (70 patients) and 2.96 ± 2.32 in 20 lesions with inconclusive uptake (18 patients). Conclusion: These results in a large group of patients indicate that 11C-choline PET/CT is a promising tool for parathyroid adenoma localization when ultrasound and 99mTc-sestamibi imaging yield negative or discordant results.