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LOS ANGELES – In patients with primary hyperparathyroidism, 18F-fluorocholine PET / CT detected more benign parathyroid tumors than high-resolution ultrasound and 99mTc-MIBI SPECT / CT imaging. neck, according to the results of a comparative study presented at the AACE Annual Scientific and Clinical Congress.
Franco Grimaldi
"The diagnosis of primary hyperparathyroidism is easy because it relies on blood biochemistry", Franco Grimaldi, MARYLAND, Head of the Endocrinology and Metabolism Unit of S. Maria della Misericordia University Hospital in Udine, Italy, said Endocrine today. "The process of locating the parathyroid is more difficult. Traditional MIBI scintigraphy and ultrasound of the neck often fail to find the parathyroid adenoma. Our data confirm that 18F-fluorocholine PET / CT has a [sensitivity] as the other methods, and this could represent a new second-line examination important for the exact pre-surgical localization of parathyroid adenomas. "
Grimaldi and his colleagues performed neck imaging with each of three techniques on 30 consecutive adults (26 women) with primary hyperparathyroidism. They also measured levels of calcium, phosphate, parathyroid hormone and bone alkaline phosphatase for each patient.
The researchers considered that an agreement between two of the three techniques was a correct result for the presence or absence of a parathyroid adenoma. PET identified a tumor in 73.3% of patients, MIBI-SPECT / CT in 40% of cases and ultrasound in 60% of cases. The concordance in the identification of a tumor was 23.3% for PET and MIBI-SPECT / CT, 46.7% for PET and ultrasound and 30% for the MIBI-SPECT / CT and ultrasound. Concordance in the absence of tumor was 10% for PET and MIBI-SPECT / CT, 13.3% for PET and ultrasound and 26.7% for MIBI-SPECT / CT and ultrasound. Ten of the patients with positive results were operated on, one of whom had persistent disease after the operation. The nine success stories were identified by PET, while MIBI-SPECT / CT identified two, and ultrasonography identified six. According to the researchers, the other patients identified as positive for a parathyroid adenoma were on hold or had undergone surgery at the time the study results were reported. Laboratory test results were not badociated with imaging results, although patients with PET-identified adenomas compared to those without statistically higher bone alkaline phosphatase levels (P = 0.03).
"Participants will be very interested in our results and their applicability to daily practice. They will certainly be looking for fluorocholine-18F PET / CT available in their own local hospitals, "said Grimaldi. – by Jill Rollet
Reference:
Grimaldi F, et al. Efficacy of 18F-Fluorocholine PET / CT, 99mTc-MIBI SPECT / CT and US High-Resolution Collar in the detection of parathyroid adenomas. Presented at: AACE Annual Scientific and Clinical Meeting; April 24 to 28, 2019; Los Angeles.
Disclosures: The authors do not report any relevant financial information.
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