Diagnostic Performances of 18F-Fluorocholine PET/CT as First-Line Functional Imaging Method for Localization of Hyperfunctioning Parathyroid Tissue in Primary Hyperparathyroidism

IF 3.8 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Academic Radiology Pub Date : 2025-02-01 DOI:10.1016/j.acra.2024.10.013

Elsa Bouilloux MD , Nicolas Santucci MD , Aurélie Bertaut MD , Jean-Louis Alberini MD, PhD , Alexandre Cochet MD, PhD , Clément Drouet MD, MSc

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引用次数: 0

Abstract

Rationale and Objectives

This study evaluated the diagnostic performance of ¹⁸F-fluorocholine (FCH) PET/CT as the first-line functional imaging method for preoperative localization of hyperfunctioning parathyroid glands (HPGs) in patients with primary hyperparathyroidism (PHPT).

Materials and Methods

This retrospective single-center study included 80 consecutive patients with PHPT, referred for FCH PET/CT between January 2018 and July 2022, and who subsequently underwent surgery. The diagnostic performance of FCH PET/CT was compared to histological results for per-lesion analysis, and to postoperative resolution of biochemical PHPT for per-patient analysis.

Results

¹⁸F-FCH-PET/CT revealed 95 positive foci in 77/80 patients and was negative in 3/80 patients. Postoperative resolution of HPT was obtained in 67/80 patients (84%). Per-lesion analysis showed 80 true positives, five true negatives, 11 false negatives, and eight false positives. Seven PET-positive foci could not be compared to histology. In a first per-lesion analysis, excluding these seven anomalies, sensitivity and positive predictive value (PPV) of FCH PET/CT were 88% (95% CI: 79–94) and 91% (95% CI: 87–94), respectively. In a second per-lesion analysis considering the seven anomalies as false positives (maximum bias analysis), PPV was 84% (95% CI: 80%–87%). By per-patient analysis, FCH PET/CT correctly identified and located all pathological glands in 56/80 (70%, 95% CI: 59–80) patients.

Conclusion

¹⁸F-Fluorocholine PET/CT appears to be an effective pre-surgical imaging method for localization of hyperfunctioning parathyroid tissue in patients with PHPT.

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18F-氟胆碱 PET/CT 作为定位原发性甲状旁腺功能亢进症甲状旁腺组织的一线功能成像方法的诊断性能

依据和目的：本研究评估了18F-氟胆碱（FCH）PET/CT作为原发性甲状旁腺功能亢进（PHPT）患者术前定位甲状旁腺功能亢进（HPGs）的一线功能成像方法的诊断性能：这项回顾性单中心研究纳入了2018年1月至2022年7月期间转诊接受FCH PET/CT检查并随后接受手术治疗的80例连续PHPT患者。在对每个病灶进行分析时，将FCH PET/CT的诊断性能与组织学结果进行比较，在对每个患者进行分析时，将FCH PET/CT的诊断性能与术后生化PHPT的缓解情况进行比较：18F-FCH-PET/CT在77/80例患者中发现了95个阳性病灶，在3/80例患者中发现了阴性病灶。67/80例患者（84%）术后HPT得到缓解。对每个病灶的分析显示，80 例为真阳性，5 例为真阴性，11 例为假阴性，8 例为假阳性。有 7 个 PET 阳性病灶无法与组织学结果进行比较。在第一次按病灶分析中，排除这七个异常病灶，FCH PET/CT 的灵敏度和阳性预测值（PPV）分别为 88%（95% CI：79-94）和 91%（95% CI：87-94）。在第二项按病灶分析中，考虑到七种异常为假阳性（最大偏倚分析），PPV 为 84%（95% CI：80%-87%）。结论：18F-氟胆碱PET/CT似乎是一种有效的术前成像方法，可用于定位PHPT患者功能亢进的甲状旁腺组织。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Academic Radiology 医学-核医学

CiteScore

7.60

自引率

10.40%

发文量

432

审稿时长

18 days

期刊介绍： Academic Radiology publishes original reports of clinical and laboratory investigations in diagnostic imaging, the diagnostic use of radioactive isotopes, computed tomography, positron emission tomography, magnetic resonance imaging, ultrasound, digital subtraction angiography, image-guided interventions and related techniques. It also includes brief technical reports describing original observations, techniques, and instrumental developments; state-of-the-art reports on clinical issues, new technology and other topics of current medical importance; meta-analyses; scientific studies and opinions on radiologic education; and letters to the Editor.