Diagnostic Performance of F-18 Fluorocholine PET/CT for Parathyroid Localization in Hyperparathyroidism: a Systematic Review and Meta-Analysis.

Abstract

The purpose of the current study was to investigate the diagnostic performance of F-18 Fluorocholine (FCH) positron emission tomography/computed tomography (PET/CT) for localization of hyperfunctioning parathyroid gland in patients with hyperparathyroidism (HPT) through a systematic review and meta-analysis. The MEDLINE/PubMed and EMBASE database, from the earliest available date of indexing through April 30, 2018, were searched for studies evaluating the diagnostic performance of F-18 FCH PET/CT for localization of hyperfunctioning parathyroid gland in patients with HPT. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves. Across eight studies (272 patients), the pooled sensitivity for F-18 FCH PET/CT was 0.90 (95% CI, 0.86-0.94) without heterogeneity (I2 = 7.1) and a pooled specificity of 0.94 (95% CI, 0.90-0.96) with heterogeneity (I2 = 79.8). Likelihood ratio (LR) syntheses gave an overall positive likelihood ratio (LR+) of 5.3 (95% CI, 1.2-24.3) and negative likelihood ratio (LR-) of 0.15 (95% CI, 0.08-0.29). The pooled diagnostic odds ratio (DOR) was 38 (95% CI, 8-174). Hierarchical summary receiver operating characteristic (ROC) curve indicates that the areas under the curve were 0.9492 (SE, 0.0215). In meta-regression analysis, no definite variable was the source of the study heterogeneity. The current meta-analysis showed the high sensitivity and specificity of F-18 FCH PET/CT for localization of hyperfunctioning parathyroid gland. At present, the literature regarding the use of F-18 FCH PET/CT for localization of hyperfunctioning parathyroid gland remains still limited; thus, further large multicenter studies would be necessary to substantiate the diagnostic accuracy of F-18 FCH PET/for localization of hyperfunctioning parathyroid gland in patients with HPT.

• Authors: Seong-Jang Kim, Sang-Woo Lee, Shin Young Jeong, Kyoungjune Pak, Keunyoung Kim
• Journal: Hormones & cancer (Horm Cancer) Vol. 9 Issue 6 Pg. 440-447 (12 2018) ISSN: 1868-8500 [Electronic] United States
• PMID: 30121878 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Radiopharmaceuticals
• fluorocholine
• Choline

Topics

• Choline (analogs & derivatives)
• Female
• Humans
• Hyperparathyroidism (diagnostic imaging)
• Male
• Parathyroid Glands (diagnostic imaging)
• Positron Emission Tomography Computed Tomography (methods)
• Radiopharmaceuticals