Departments of Head and Neck Surgery.
Department of Medical Science, Nuclear Medicine Unit, University of Turin.
Clin Nucl Med. 2022 Feb 1;47(2):101-107. doi: 10.1097/RLU.0000000000003987.
The aim of this study was to assess the relationship between the histopathological properties of hyperfunctioning parathyroids and parathyroid 18F-choline uptake.
A total of 31 parathyroid adenomas were retrospectively analyzed in patients with primary hyperparathyroidism and preoperative 18F-choline PET/MR. PET/MR parameters of parathyroid glands (SUVmax and target-to-background ratio in early-phase [EP] and late-phase [LP]), MRI volume, preoperative parathyroid hormone (PTH) serum concentration, and postoperative histopathology (predominant cell type and growth pattern of adenoma cells, location and size of adenoma) were assessed. The relationship of PET/MR parameters, PTH, and histological parameters was determined using linear regression, Spearman correlation and Kruskal-Wallis test.
The median volume of parathyroid adenoma was 421.78 ± 142.46 mm3 (46.39-4412.69). Adenomas were predominantly composed of chief, water-clear, and oncocytic/oxyphilic cells in 27/31, 2/31, and 2/31 cases, respectively. The growth pattern was predominantly solid, follicular, and trabecular in 18/31, 8/31, and 5/31, respectively. The SUVmax was 6.71 ± 3.39 in EP and 6.91 ± 3.97 in LP. Follicular growth pattern had slightly higher EP SUVmax (trabecular: 4.12 ± 0.56; solid: 6.62 ± 3.19; follicular: 8.56 ± 3.96; P = 0.046). Spearman correlation showed strong positive correlation between volume and both EP and LP SUVmax (0.626; P = 0.0001 and 0.576; P = 0.0001, respectively). Linear regression analysis revealed significant correlation between PTH level and EP and LP SUVmax (both P = 0.001); in contrast, no correlation was found between PTH level and both cell type and growth pattern.
Our findings suggest that 18F-choline uptake of parathyroid adenomas might be associated both with the histological growth pattern and adenoma volume, but not with a specific cell type.
本研究旨在评估功能亢进甲状旁腺的组织病理学特性与甲状旁腺 18F-胆碱摄取之间的关系。
回顾性分析了 31 例原发性甲状旁腺功能亢进症患者术前 18F-胆碱 PET/MR 检查的甲状旁腺腺瘤。评估甲状旁腺的 PET/MR 参数（早期 [EP] 和晚期 [LP] 的 SUVmax 和靶-本底比）、MRI 体积、术前甲状旁腺激素（PTH）血清浓度和术后组织病理学（腺瘤细胞的主要细胞类型和生长模式、腺瘤的位置和大小）。使用线性回归、Spearman 相关和 Kruskal-Wallis 检验确定 PET/MR 参数、PTH 和组织学参数之间的关系。
甲状旁腺腺瘤的中位体积为 421.78±142.46mm3（46.39-4412.69）。27/31、2/31 和 2/31 例腺瘤分别主要由主细胞、水样透明细胞和嗜酸性/嗜碱性细胞组成。18/31、8/31 和 5/31 例腺瘤的生长模式分别主要为实性、滤泡状和小梁状。EP 的 SUVmax 为 6.71±3.39，LP 的 SUVmax 为 6.91±3.97。滤泡状生长模式的 EP SUVmax 略高（小梁状：4.12±0.56；实性：6.62±3.19；滤泡状：8.56±3.96；P=0.046）。Spearman 相关性分析显示，体积与 EP 和 LP SUVmax 之间呈强正相关（0.626；P=0.0001 和 0.576；P=0.0001）。线性回归分析显示，PTH 水平与 EP 和 LP SUVmax 之间存在显著相关性（均 P=0.001）；相反，PTH 水平与细胞类型和生长模式之间均无相关性。
我们的研究结果表明，甲状旁腺腺瘤的 18F-胆碱摄取可能与组织学生长模式和腺瘤体积有关，但与特定的细胞类型无关。
