[<sup>18</sup>F]fluoro-ethylcholine-PET Plus 4D-CT (FEC-PET-CT): A Break-Through Tool to Localize the “Negative” Parathyroid Adenoma. One Year Follow Up Results Involving 170 Patients
Background: The diagnostic performance of [<sup>18</sup>F]fluoro-ethylcholine-PET-CT&4D-CT (FEC-PET&4D-CT) to identify parathyroid adenomas (PA) was analyzed when ultrasound (US) or MIBI-Scan (MS) failed to localize. Postsurgical one year follow-up data are presented. Methods: Pa...
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doaj-b56090f3c2574a31a582eed2774d73012021-04-13T23:01:21ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01101648164810.3390/jcm10081648[<sup>18</sup>F]fluoro-ethylcholine-PET Plus 4D-CT (FEC-PET-CT): A Break-Through Tool to Localize the “Negative” Parathyroid Adenoma. One Year Follow Up Results Involving 170 PatientsConstantin Smaxwil0Philip Aschoff1Gerald Reischl2Mirjam Busch3Joachim Wagner4Julia Altmeier5Oswald Ploner6Andreas Zielke7Department of Endocrine Surgery, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Nuclear Medicine and PET-CT Centre, Institute of Diagnostic and Interventional Radiology, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Preclinical Imaging and Radiopharmacy, Werner Siemens Imaging Center, Eberhard Karls University of Tuebingen, 72076 Tuebingen, GermanyDepartment of Endocrine Surgery, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Endocrine Surgery, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Endocrine Surgery, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Internal Medicine, Endocrinology, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyDepartment of Endocrine Surgery, Endokrines Zentrum Stuttgart, Diakonie-Klinikum Stuttgart, 70176 Stuttgart, GermanyBackground: The diagnostic performance of [<sup>18</sup>F]fluoro-ethylcholine-PET-CT&4D-CT (FEC-PET&4D-CT) to identify parathyroid adenomas (PA) was analyzed when ultrasound (US) or MIBI-Scan (MS) failed to localize. Postsurgical one year follow-up data are presented. Methods: Patients in whom US and MS delivered either incongruent or entirely negative findings were subjected to FEC-PET&4D-CT and cases from July 2017 to June 2020 were analyzed, retrospectively. Cervical exploration with intraoperative PTH-monitoring (IO-PTH) was performed. Imaging results were correlated to intraoperative findings, and short term and one year postoperative follow-up data. Results: From July 2017 to June 2020 in 171 FEC-PET&4D-CTs 159 (92.9%) PAs were suggested. 147 patients already had surgery, FEC-PET&4D-CT accurately localized in 141; false neg. 4, false pos. 2, global sensitivity 0.97; accuracy 0.96, PPV 0.99. All of the 117 patients that already have completed their 12-month postoperative follow up had normal biochemical parameter, i.e., no signs of persisting disease. However, two cases may have a potential for recurrent disease, for a cure rate of at least 98.3%. Conclusion: FEC-PET&4D-CT shows unprecedented results regarding the accuracy localizing PAs. The one-year-follow-up data demonstrate a high cure rate. We, therefore, suggest FEC-PET-CT as the relevant diagnostic tool for the localization of PAs when US fails to localize PA, especially after previous surgery to the neck.https://www.mdpi.com/2077-0383/10/8/1648parathyroid adenomahyperparathyroidismPET-CTFECFCH |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Constantin Smaxwil Philip Aschoff Gerald Reischl Mirjam Busch Joachim Wagner Julia Altmeier Oswald Ploner Andreas Zielke |
spellingShingle |
Constantin Smaxwil Philip Aschoff Gerald Reischl Mirjam Busch Joachim Wagner Julia Altmeier Oswald Ploner Andreas Zielke [<sup>18</sup>F]fluoro-ethylcholine-PET Plus 4D-CT (FEC-PET-CT): A Break-Through Tool to Localize the “Negative” Parathyroid Adenoma. One Year Follow Up Results Involving 170 Patients Journal of Clinical Medicine parathyroid adenoma hyperparathyroidism PET-CT FEC FCH |
author_facet |
Constantin Smaxwil Philip Aschoff Gerald Reischl Mirjam Busch Joachim Wagner Julia Altmeier Oswald Ploner Andreas Zielke |
author_sort |
Constantin Smaxwil |
title |
[<sup>18</sup>F]fluoro-ethylcholine-PET Plus 4D-CT (FEC-PET-CT): A Break-Through Tool to Localize the “Negative” Parathyroid Adenoma. One Year Follow Up Results Involving 170 Patients |
title_short |
[<sup>18</sup>F]fluoro-ethylcholine-PET Plus 4D-CT (FEC-PET-CT): A Break-Through Tool to Localize the “Negative” Parathyroid Adenoma. One Year Follow Up Results Involving 170 Patients |
title_full |
[<sup>18</sup>F]fluoro-ethylcholine-PET Plus 4D-CT (FEC-PET-CT): A Break-Through Tool to Localize the “Negative” Parathyroid Adenoma. One Year Follow Up Results Involving 170 Patients |
title_fullStr |
[<sup>18</sup>F]fluoro-ethylcholine-PET Plus 4D-CT (FEC-PET-CT): A Break-Through Tool to Localize the “Negative” Parathyroid Adenoma. One Year Follow Up Results Involving 170 Patients |
title_full_unstemmed |
[<sup>18</sup>F]fluoro-ethylcholine-PET Plus 4D-CT (FEC-PET-CT): A Break-Through Tool to Localize the “Negative” Parathyroid Adenoma. One Year Follow Up Results Involving 170 Patients |
title_sort |
[<sup>18</sup>f]fluoro-ethylcholine-pet plus 4d-ct (fec-pet-ct): a break-through tool to localize the “negative” parathyroid adenoma. one year follow up results involving 170 patients |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2021-04-01 |
description |
Background: The diagnostic performance of [<sup>18</sup>F]fluoro-ethylcholine-PET-CT&4D-CT (FEC-PET&4D-CT) to identify parathyroid adenomas (PA) was analyzed when ultrasound (US) or MIBI-Scan (MS) failed to localize. Postsurgical one year follow-up data are presented. Methods: Patients in whom US and MS delivered either incongruent or entirely negative findings were subjected to FEC-PET&4D-CT and cases from July 2017 to June 2020 were analyzed, retrospectively. Cervical exploration with intraoperative PTH-monitoring (IO-PTH) was performed. Imaging results were correlated to intraoperative findings, and short term and one year postoperative follow-up data. Results: From July 2017 to June 2020 in 171 FEC-PET&4D-CTs 159 (92.9%) PAs were suggested. 147 patients already had surgery, FEC-PET&4D-CT accurately localized in 141; false neg. 4, false pos. 2, global sensitivity 0.97; accuracy 0.96, PPV 0.99. All of the 117 patients that already have completed their 12-month postoperative follow up had normal biochemical parameter, i.e., no signs of persisting disease. However, two cases may have a potential for recurrent disease, for a cure rate of at least 98.3%. Conclusion: FEC-PET&4D-CT shows unprecedented results regarding the accuracy localizing PAs. The one-year-follow-up data demonstrate a high cure rate. We, therefore, suggest FEC-PET-CT as the relevant diagnostic tool for the localization of PAs when US fails to localize PA, especially after previous surgery to the neck. |
topic |
parathyroid adenoma hyperparathyroidism PET-CT FEC FCH |
url |
https://www.mdpi.com/2077-0383/10/8/1648 |
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