Abstract | BACKGROUND: METHODS: Patients with primary hyperparathyroidism and indications for parathyroidectomy had simultaneous 18F-fluorocholine positron emission tomography imaging/magnetic resonance imaging. In patients who underwent subsequent parathyroidectomy, cure was based on lab values at least 6 months after surgery. Location-based sensitivity and specificity of 18F-fluorocholine positron emission tomography imaging was assessed using 3 anatomic locations (left neck, right neck, and mediastinum), with surgery as the gold standard. RESULTS: In 101 patients, 18F-fluorocholine positron emission tomography localized at least 1 candidate lesion in 93% of patients overall and in 91% of patients with previously negative imaging, leading to a change in preoperative strategy in 60% of patients. Of 76 patients who underwent parathyroidectomy, 58 (77%) had laboratory data at least 6 months postoperatively, with 55/58 patients (95%) demonstrating cure. 18F-fluorocholine positron emission tomography successfully guided curative surgery in 48/58 (83%) patients, compared with 20/57 (35%) based on ultrasound and 13/55 (24%) based on sestamibi. In a location-based analysis, sensitivity of 18F-fluorocholine positron emission tomography (88.9%) outperformed both ultrasound (37.1%) and sestamibi (27.5%), as well as ultrasound and sestamibi combined (47.8%). CONCLUSION: Long-term results in the first cohort in the United States to use 18F-fluorocholine positron emission tomography for parathyroid localization confirm its utility in a challenging cohort, with better sensitivity than ultrasound or sestamibi.
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Authors | Claire E Graves, Thomas A Hope, Jina Kim, Miguel H Pampaloni, Wouter Kluijfhout, Carolyn D Seib, Jessica E Gosnell, Wen T Shen, Sanziana A Roman, Julie A Sosa, Quan-Yang Duh, Insoo Suh |
Journal | Surgery
(Surgery)
Vol. 171
Issue 1
Pg. 47-54
(01 2022)
ISSN: 1532-7361 [Electronic] United States |
PMID | 34301418
(Publication Type: Clinical Trial, Phase II, Clinical Trial, Phase III, Comparative Study, Journal Article, Research Support, N.I.H., Extramural)
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Copyright | Copyright © 2021 Elsevier Inc. All rights reserved. |
Chemical References |
- Fluorine Radioisotopes
- fluorocholine
- Technetium Tc 99m Sestamibi
- Choline
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Topics |
- Aged
- Choline
(administration & dosage, analogs & derivatives)
- Female
- Fluorine Radioisotopes
(administration & dosage)
- Humans
- Hyperparathyroidism, Primary
(diagnosis, etiology, pathology, surgery)
- Magnetic Resonance Imaging
(statistics & numerical data)
- Male
- Middle Aged
- Parathyroid Glands
(diagnostic imaging, pathology, surgery)
- Parathyroid Neoplasms
(complications, diagnosis, pathology, surgery)
- Parathyroidectomy
(statistics & numerical data)
- Positron-Emission Tomography
(methods, statistics & numerical data)
- Preoperative Care
(methods, statistics & numerical data)
- Technetium Tc 99m Sestamibi
(administration & dosage)
- Treatment Outcome
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