Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California.
Department of Radiology, San Francisco VA Medical Center, San Francisco, California.
J Nucl Med. 2021 Nov;62(11):1511-1516. doi: 10.2967/jnumed.120.256735. Epub 2021 Mar 5.
The purpose of this prospective study was to determine the correct localization rate (CLR) of F-fluorocholine PET for the detection of parathyroid adenomas in comparison to Tc-sestamibi imaging. This was a single-arm prospective trial. Ninety-eight patients with biochemical evidence of primary hyperparathyroidism were imaged before parathyroidectomy using F-fluorocholine PET/MRI. Tc-sestamibi imaging performed separately from the study was evaluated for comparison. The primary endpoint of the study was the CLR on a patient level. Each imaging study was interpreted by 3 masked readers on a per-region basis. Lesions were validated by histopathologic analysis of surgical specimens. Of the 98 patients who underwent F-fluorocholine PET, 77 subsequently underwent parathyroidectomy and 60 of those had Tc-sestamibi imaging. For F-fluorocholine PET in patients who underwent parathyroidectomy, the CLR based on the masked reader consensus was 75% (95% CI, 0.63-0.82). In patients who underwent surgery and had an available Tc-sestamibi study, the CLR increased from 17% (95% CI, 0.10-0.27) for Tc-sestamibi imaging to 70% (95% CI, 0.59-0.79) for F-fluorocholine PET. In this prospective study using masked readers, the CLR for F-fluorocholine PET was 75%. In patients with a paired Tc-sestamibi study, the use of F-fluorocholine PET increased the CLR from 17% to 70%. F-fluorocholine PET is a superior imaging modality for the localization of parathyroid adenomas.
这项前瞻性研究的目的是确定 F-氟代胆碱 PET 在检测甲状旁腺腺瘤方面的正确定位率 (CLR)，并与 Tc- sestamibi 成像进行比较。这是一项单臂前瞻性试验。98 例生化证据表明患有原发性甲状旁腺功能亢进症的患者在甲状旁腺切除术前行 F-氟代胆碱 PET/MRI 成像。单独进行的 Tc-sestamibi 成像用于比较。该研究的主要终点是患者水平上的 CLR。每位患者的每一个成像研究都由 3 位掩蔽读者进行评估。根据手术标本的组织病理学分析验证病变。在接受 F-氟代胆碱 PET 的 98 例患者中，77 例随后接受了甲状旁腺切除术，其中 60 例接受了 Tc-sestamibi 成像。对于接受甲状旁腺切除术的患者，基于掩蔽读者共识的 F-氟代胆碱 PET 的 CLR 为 75%（95%CI，0.63-0.82）。在接受手术且有 Tc-sestamibi 研究结果的患者中，CLR 从 Tc-sestamibi 成像的 17%（95%CI，0.10-0.27）增加到 F-氟代胆碱 PET 的 70%（95%CI，0.59-0.79）。在这项使用掩蔽读者的前瞻性研究中，F-氟代胆碱 PET 的 CLR 为 75%。在有配对 Tc-sestamibi 研究的患者中，使用 F-氟代胆碱 PET 将 CLR 从 17%增加到 70%。F-氟代胆碱 PET 是甲状旁腺腺瘤定位的一种优越的成像方式。
