Affiliation:
1. University Hospital Centre Zagreb, Kispaticeva 12, 10000 Zagreb,
Croatia
Abstract
Abstract
Objective This study aimed to assess the diagnostic performance of
99mTc-sestamibi SPECT/CT and 18F-choline PET/CT in
detecting hyperfunctioning parathyroid glands in patients undergoing surgery for
primary hyperparathyroidism (PHPT).
Methods A retrospective analysis was conducted on patients who underwent
PHPT-related surgery between April 2019 and May 2022. The study focused on
patients undergoing either 99mTc-sestamibi SPECT/CT (81 patients) or
18F-choline PET/CT (33 patients) scans before surgery to pinpoint
hyperfunctioning parathyroid gland(s). In the majority of patients,
18F-choline PET/CT was performed after negative or inconclusive
findings on 99mTc-sestamibi SPECT/CT. Pathohistological reports were
utilized as the reference standard for evaluating the accuracy of the imaging
findings.
Results The study encompassed 83 patients (70 females, 84.3%) with an
average age of 57.2 years (24–80 years). The pathohistological analysis
identified a total of 98 glands. In a per-lesion analysis, the detection rate of
99mTc-sestamibi SPECT/CT was 57% (95% CI 45.3–68.1), while the
detection rate of 18F-choline PET/CT was 90.3% (95% CI
74.3–98.0).
Conclusion The results of our study showed the significant usefulness of
18F-choline PET/CT in patients with negative or inconclusive
results of 99mTc-sestamibi SPECT/CT in accurately locating
hyperfunctioning parathyroid glands in PHPT patients.