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López-Mora, Diego Alfonso; Sizova, Marina; Estorch, Montserrat; Flotats, Albert; Camacho, Valle; Fernández, Alejandro; Abouzian, Safae; Fuentes-Ocampo, Francisco; Garcia, José Ignacio Pérez; Ballesteros, Ana Isabel Chico; Duch, Joan; Domènech, Anna; Duarte, Antonio Moral; Carrió, Ignasi
European journal of nuclear medicine and molecular imaging, 03/2020, Letnik: 47, Številka: 3Journal Article
Objective To compare detectability of hyperfunctioning parathyroid tissue (HPT) by digital and analog 18F-fluorocholine PET/CT in patients with primary hyperparathyroidism and negative/inconclusive 99mTc-MIBI scintigraphy-SPECT/CT. Materials and methods Thirty-three patients with primary hyperparathyroidism and negative/inconclusive 99mTc-MIBI scintigraphy-SPECT/CT were prospectively included. All patients accepted to be scanned by digital and analog PET/CT in the same imaging session after a single injection of 18F-fluorocholine. Three nuclear medicine physicians evaluated the digital and analog PET/CT datasets to assess the detection rate of HPT. Maximum standard uptake values (SUVmax) of HPT and locoregional lymph nodes were measured in both systems. Results HPT was detected in 30/33 patients by the digital system, whereas it was detected in 22/33 patients by the analog system ( p < 0.01). Moreover, in 21 of these 33 patients, both systems detected one focal 18F-fluorocholine uptake, and in one patient the digital system detected two foci. Histopathology demonstrated HPT in 32 patients and it was inconclusive in one patient. The digital PET/CT detected HPT in 29 of the 32 patients, and the analog system in 22 of the 32 ( p < 0.01). All HPT suspected lesions resected and detected only by the digital system ( n = 8) were < 10 mm (7.5 ± 1.3 mm), while those detected by both systems ( n = 22) were > 10 mm (13 ± 3.8 mm). SUVmax of HPT lesions was significantly higher than SUVmax of locoregional lymph node independently of the PET/CT system used (4.5 ± 1.9 vs. 2.9 ± 1.3, p < 0.0001). Conclusions Digital PET/CT offers superior performance over analog system in patients with suspected HPT and previous negative/inconclusive imaging examinations, particularly in sub-centimeter lesions. SUVmax can help in the differentiation between HTP and locoregional lymph nodes.
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JCR | SNIP | JCR | SNIP | JCR | SNIP | JCR | SNIP |
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