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Retrospective real-life study on preoperative imaging for minimally invasive parathyroidectomy in primary hyperparathyroidism
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Retrospective real-life study on preoperative imaging for minimally invasive parathyroidectomy in primary hyperparathyroidism
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Journal Article
Retrospective real-life study on preoperative imaging for minimally invasive parathyroidectomy in primary hyperparathyroidism
2022
Overview
The objective of this study was to retrospectively evaluate preoperative imaging modalities for localization of parathyroid adenomas with a view to enable minimally invasive parathyroidectomy and in particular, to consider the contribution of
18
F-fluorocholine-PET/CT. 104 patients with primary hyperparathyroidism, who underwent parathyroid surgery in a single centre during a 6-year period were included. Of these, 103 underwent ultrasound, 97
99m
Tc-Pertechnetate/SestaMIBI-SPECT, 20 MRI and 30
18
F-fluorocholine-PET/CT. Based on surgical findings, sensitivities and specificities for correct lateralisation in orthotopic locations were: for ultrasound 0.75 (0.65–0.83) and 0.89 (0.81–0.94), for
99m
Tc-MIBI-SPECT 0.57 (0.46–0.67) and 0.97 (0.91–0.99), for MRI 0.60 (0.36–0.81) and 0.83 (0.59–0.96) and for
18
F-fluorocholine-PET/CT 0.90 (0.73–0.98) and 0.90 (0.73–0.98). Correctly lateralized adenomas were significantly larger than those not found with ultrasound (p = 0.03) and SPECT (p = 0.002). Pre-operative PTH-levels were higher in single adenomas detected by scintigraphy than in those not (p = 0.02). 64 patients could be treated with a minimally invasive procedure. Cure after parathyroidectomy was obtained in 94% of patients.
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F-Fluorocholine-PET/CT could be shown to be a highly accurate modality to localize parathyroid adenomas preoperatively, obviating the need for total exploration in the majority of patients in whom ultrasound and scintigraphic results are discordant or both negative.
Publisher
Nature Publishing Group UK,Nature Publishing Group,Nature Portfolio
Subject
/ 692/699
/ Adenoma - diagnostic imaging
/ Humanities and Social Sciences
/ Humans
/ Hyperparathyroidism, Primary - diagnostic imaging
/ Hyperparathyroidism, Primary - surgery
/ Parathyroid Glands - surgery
/ Parathyroid Neoplasms - diagnostic imaging
/ Parathyroid Neoplasms - surgery
/ Patients
/ Positron Emission Tomography Computed Tomography
/ Science
/ Single photon emission computed tomography
/ Tomography, Emission-Computed, Single-Photon
/ Tumors
