Noltes M E, Kruijff S, Jansen L, Westerlaan H E, Zandee W T, Dierckx R A J O, Brouwers A H
Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands.
Department of Surgical Oncology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
EJNMMI Res. 2021 Mar 26;11(1):32. doi: 10.1186/s13550-021-00778-7.
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 C-choline PET/CT in patients with pHPT as a next in-line scan after primary negative or discordant first-line imaging.
This was a retrospective single-center cohort study. All patients with pHPT that were scanned utilizing C-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 C-choline PET/CT were evaluated lesion-based, with surgical exploration and histopathological examination as the gold standard.
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 C-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 C-choline PET/CT was 97%, the positive predictive value was 95% and the accuracy was 94% for all parathyroid lesions.
In patients with pHPT and prior negative or discordant first-line imaging results, pathological parathyroid glands can be localized by C-choline PET/CT with high sensitivity and accuracy.
确定原发性甲状旁腺功能亢进症（pHPT）患者甲状旁腺腺瘤的正确位置至关重要，因为这可以指导手术治疗。本研究旨在确定C-胆碱PET/CT在pHPT患者中的诊断性能，作为一线成像为阴性或不一致后的下一步扫描。
这是一项回顾性单中心队列研究。纳入2015年至2019年间所有在先前成像为阴性或不一致后接受C-胆碱PET/CT扫描且随后接受甲状旁腺手术的pHPT患者。以手术探查和组织病理学检查作为金标准，基于病变评估C-胆碱PET/CT的结果。
总共纳入36例患者，其中3例已知患有多发性内分泌肿瘤（MEN）综合征。在这36例患者中，C-胆碱PET/CT上发现40个病变，37个甲状旁腺病变被手术切除。34/36（94%）例患者进行了聚焦甲状旁腺切除术，1例患者因异位腺瘤进行了颈部探查，1例患者因双腺瘤进行了双侧探查。总体而言，C-胆碱PET/CT对所有甲状旁腺病变的每病变敏感性为97%，阳性预测值为95%，准确性为94%。
在pHPT且一线成像结果先前为阴性或不一致的患者中，C-胆碱PET/CT可以高敏感性和准确性定位病理性甲状旁腺。
