1. Accuracy of 18F-Fluorocholine PET for the Detection of Parathyroid Adenomas: Prospective Single-Center Study.
- Author
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Hope, Thomas A, Graves, Claire E, Calais, Jeremie, Ehman, Eric C, Johnson, Geoffrey B, Thompson, Daniel, Aslam, Maya, Duh, Quan-Yang, Gosnell, Jessica E, Shen, Wen T, Roman, Sanziana A, Sosa, Julie A, Kluijfhout, Wouter P, Seib, Carolyn D, Villaneuva-Meyer, Javier E, Pampaloni, Miguel H, and Suh, Insoo
- Subjects
Humans ,Parathyroid Neoplasms ,Choline ,Technetium Tc 99m Sestamibi ,Adult ,Aged ,Middle Aged ,Positron Emission Tomography Computed Tomography ,PET ,endocrine ,fluorocholine ,hyperparathyroidism ,parathyroid adenomas ,Biomedical Imaging ,Clinical Research ,4.2 Evaluation of markers and technologies ,Detection ,screening and diagnosis ,Clinical Sciences ,Nuclear Medicine & Medical Imaging - Abstract
The purpose of this prospective study was to determine the correct localization rate (CLR) of 18F-fluorocholine PET for the detection of parathyroid adenomas in comparison to 99mTc-sestamibi imaging. Methods: This was a single-arm prospective trial. Ninety-eight patients with biochemical evidence of primary hyperparathyroidism were imaged before parathyroidectomy using 18F-fluorocholine PET/MRI. 99mTc-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. Results: Of the 98 patients who underwent 18F-fluorocholine PET, 77 subsequently underwent parathyroidectomy and 60 of those had 99mTc-sestamibi imaging. For 18F-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 99mTc-sestamibi study, the CLR increased from 17% (95% CI, 0.10-0.27) for 99mTc-sestamibi imaging to 70% (95% CI, 0.59-0.79) for 18F-fluorocholine PET. Conclusion: In this prospective study using masked readers, the CLR for 18F-fluorocholine PET was 75%. In patients with a paired 99mTc-sestamibi study, the use of 18F-fluorocholine PET increased the CLR from 17% to 70%. 18F-fluorocholine PET is a superior imaging modality for the localization of parathyroid adenomas.
- Published
- 2021