Diagnostic Performance of 18 F-Choline Positron Emission Tomography/Contrast-Enhanced Computed Tomography in Adenoma Detection in Primary Hyperparathyroidism after Inconclusive Imaging: A Retrospective Study of 215 Patients.
Johan BenjaminLaure MaillardIsabelle MorelecPhilippe GotFrançoise Borson-ChazotJean-Christophe LifantePublished in: Cancers (2022)
This large, retrospective, single-centre study evaluated the diagnostic performance of 18 F-choline positron emission tomography/contrast-enhanced computed tomography (PET/ceCT) in preoperative parathyroid adenoma detection in primary hyperparathyroidism cases after negative/inconclusive ultrasound or other imaging findings. We included patients who underwent surgery and 18 F-choline PET/ceCT for inconclusive imaging results between 2015 and 2020. We compared the 18 F-choline PET/ceCT results with surgical and histopathological findings and identified the variables influencing the correlation between 18 F-choline PET/ceCT and surgical findings. Of 215 enrolled patients, 269 glands (mean lesion size, 10.9 ± 8.0 mm) were analysed. There were 165 unilocular and 50 multilocular lesions; the mean preoperative calcium level was 2.18 ± 0.19 mmol/L. Among 860 estimated lesions, 219 were classified as true positive, 21 as false positive, and 28 as false negative. The per-lesion sensitivity was 88.66%; specificity, 96.57%; positive predictive value, 91.40%; and negative predictive value, 95.39%. The detection and cure rates were 82.0% and 95.0%, respectively. On univariate and multivariate analyses, the maximum standardised uptake value (SUVmax), lesion size, and unilocularity correlated with the pathologic findings of hyperfunctioning glands. 18 F-choline PET/ceCT presents favourable diagnostic performance as a second-line imaging method, with SUVmax, lesion size, and unilocularity predicting a high correlation between the 18 F-choline PET/ceCT and surgical findings.
Keyphrases
- positron emission tomography
- computed tomography
- contrast enhanced
- magnetic resonance imaging
- diffusion weighted
- pet ct
- high resolution
- end stage renal disease
- pet imaging
- dual energy
- image quality
- newly diagnosed
- magnetic resonance
- peritoneal dialysis
- ejection fraction
- prognostic factors
- patients undergoing
- label free
- diffusion weighted imaging
- squamous cell carcinoma
- real time pcr
- radiation therapy
- minimally invasive
- lymph node
- fluorescence imaging
- atrial fibrillation
- mass spectrometry
- structural basis
- ultrasound guided
- coronary artery disease