Accuracy of 18F-Fluorocholine PET for the Detection of Parathyroid Adenomas: Prospective Single-Center Study.

Abstract

The purpose of this prospective study was to determine the correct localization rate (CLR) of 18F-fluorocholine PET for the detection of parathyroid adenomas in comparison to 99mTc-sestamibi imaging. Methods: This was a single-arm prospective trial. Ninety-eight patients with biochemical evidence of primary hyperparathyroidism were imaged before parathyroidectomy using 18F-fluorocholine PET/MRI. 99mTc-sestamibi imaging performed separately from the study was evaluated for comparison. The primary endpoint of the study was the CLR on a patient level. Each imaging study was interpreted by 3 masked readers on a per-region basis. Lesions were validated by histopathologic analysis of surgical specimens. Results: Of the 98 patients who underwent 18F-fluorocholine PET, 77 subsequently underwent parathyroidectomy and 60 of those had 99mTc-sestamibi imaging. For 18F-fluorocholine PET in patients who underwent parathyroidectomy, the CLR based on the masked reader consensus was 75% (95% CI, 0.63-0.82). In patients who underwent surgery and had an available 99mTc-sestamibi study, the CLR increased from 17% (95% CI, 0.10-0.27) for 99mTc-sestamibi imaging to 70% (95% CI, 0.59-0.79) for 18F-fluorocholine PET. Conclusion: In this prospective study using masked readers, the CLR for 18F-fluorocholine PET was 75%. In patients with a paired 99mTc-sestamibi study, the use of 18F-fluorocholine PET increased the CLR from 17% to 70%. 18F-fluorocholine PET is a superior imaging modality for the localization of parathyroid adenomas.

• Authors: Thomas A Hope, Claire E Graves, Jeremie Calais, Eric C Ehman, Geoffrey B Johnson, Daniel Thompson, Maya Aslam, Quan-Yang Duh, Jessica E Gosnell, Wen T Shen, Sanziana A Roman, Julie A Sosa, Wouter P Kluijfhout, Carolyn D Seib, Javier E Villaneuva-Meyer, Miguel H Pampaloni, Insoo Suh
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 62 Issue 11 Pg. 1511-1516 (11 2021) ISSN: 1535-5667 [Electronic] United States
• PMID: 33674400 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: © 2021 by the Society of Nuclear Medicine and Molecular Imaging.

Chemical References

• fluorocholine
• Technetium Tc 99m Sestamibi
• Choline

Topics

• Adult
• Aged
• Choline (analogs & derivatives)
• Humans
• Middle Aged
• Parathyroid Neoplasms
• Positron Emission Tomography Computed Tomography
• Technetium Tc 99m Sestamibi