Department of Nuclear Medicine, University Hospital Zurich / University of Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Department of Neuroradiology, University Hospital Zurich, Frauenklinikstrasse 10, Zurich, 8091, Switzerland.
Mol Imaging Biol. 2018 Oct;20(5):857-867. doi: 10.1007/s11307-018-1179-x.
The aim of the study was to investigate the relationship between [F]fluoromethyl-dimethyl-2-hydroxyethylammonium ([F]FCh) positron emission tomography (PET) parameters, laboratory parameters, and postoperative histopathological results in patients with primary hyperparathyroidism (pHPT) due to parathyroid adenomas.
This retrospective study was conducted in 52 patients with biochemically proven pHPT. [F]FCh-PET parameters (maximum standardized uptake value: SUV in early phase (after 2 min) and late phase (after 50 min), metabolic volume, and adenoma-to-background ratio (ABR), preoperative laboratory results (PTH and serum calcium concentration), and postoperative histopathology (location, size, volume, and weight of adenoma) were assessed. Relationship of PET parameters, laboratory parameters, and histopathological parameters was assessed using the Mann-Whitney U test and Spearman correlation coefficient. MRI characteristics of parathyroid adenomas were also analyzed.
The majority of patients underwent a PET/MR scan, 42 patients (80.7 %); 10 patients (19.3 %) underwent PET/CT. We found a strong positive correlation between late-phase SUV and preoperative PTH level (r = 0.768, p < 0.001) and between late-phase ABR and preoperative PTH level (r = 0.680, p < 0.001). The surgical specimen volume was positively correlated with the PET/MR lesion volume (r = 0.659, p < 0.001). No significant association was observed between other [F]FCh-PET parameters, laboratory parameters, and histopathological findings. Cystic adenomas were larger than non-cystic adenomas (p = 0.048).
[F]FCh uptake of parathyroid adenomas is strongly correlated with preoperative PTH serum concentration. Therefore, the preoperative PTH level might potentially be able to predict success of [F]FCh-PET imaging in hyperparathyroidism, with higher lesion-to-background ratios being expected in patients with high PTH. PET/MR is accurate in estimating the volume of parathyroid adenomas.
本研究旨在探讨原发性甲状旁腺功能亢进（pHPT）患者因甲状旁腺腺瘤引起的[F]氟甲基-二甲基-2-羟乙基铵（[F]FCh）正电子发射断层扫描（PET）参数与实验室参数及术后组织病理学结果之间的关系。
这是一项回顾性研究，共纳入 52 例经生化证实的 pHPT 患者。评估[F]FCh-PET 参数（早期（2 分钟后）和晚期（50 分钟后）最大标准化摄取值 SUV、代谢体积和腺瘤背景比（ABR），术前实验室结果（PTH 和血清钙浓度），以及术后组织病理学（腺瘤位置、大小、体积和重量）。使用 Mann-Whitney U 检验和 Spearman 相关系数评估 PET 参数、实验室参数和组织病理学参数之间的关系。还分析了甲状旁腺腺瘤的 MRI 特征。
大多数患者接受了 PET/MR 扫描（42 例，80.7%），10 例患者（19.3%）接受了 PET/CT 检查。我们发现晚期 SUV 与术前 PTH 水平之间存在很强的正相关（r=0.768，p<0.001），晚期 ABR 与术前 PTH 水平之间也存在很强的正相关（r=0.680，p<0.001）。手术标本体积与 PET/MR 病变体积呈正相关（r=0.659，p<0.001）。其他[F]FCh-PET 参数、实验室参数和组织病理学发现之间无显著相关性。囊性腺瘤大于非囊性腺瘤（p=0.048）。
甲状旁腺腺瘤的[F]FCh 摄取与术前 PTH 血清浓度强烈相关。因此，术前 PTH 水平可能能够预测甲状旁腺亢进[F]FCh-PET 成像的成功率，预计 PTH 较高的患者会有更高的病灶与背景比。PET/MR 能准确估计甲状旁腺腺瘤的体积。
