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Diagnostic utility of 11 C-methionine PET/CT in primary hyperparathyroidism in a UK cohort: A single-centre experience and literature review.
Huynh, Kevin A; MacFarlane, James; Newman, Christine; Gillett, Daniel; Das, Tilak; Scoffings, Daniel; Cheow, Heok K; Moyle, Penelope; Koulouri, Olympia; Harper, Ines; Aloj, Luigi; Mendichovszky, Iosif A; Inchiappa, Danilo; Buch, Harit N; Chung, Teng-Teng; Simpson, Helen L; Powlson, Andrew S; Challis, Ben G; Bashari, Waiel A; Stokes, Victoria J; Masterson, Liam; Jani, Piyush; Fish, Brian; Gurnell, Mark; Casey, Ruth T.
Affiliation
  • Huynh KA; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • MacFarlane J; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Newman C; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Gillett D; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Das T; Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Scoffings D; Department of Radiology, University of Cambridge, Cambridge, UK.
  • Cheow HK; Department of Radiology, University of Cambridge, Cambridge, UK.
  • Moyle P; Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Koulouri O; Department of Radiology, University of Cambridge, Cambridge, UK.
  • Harper I; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Aloj L; Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Mendichovszky IA; Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Inchiappa D; Department of Radiology, University of Cambridge, Cambridge, UK.
  • Buch HN; Department of Nuclear Medicine, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Chung TT; Department of Radiology, University of Cambridge, Cambridge, UK.
  • Simpson HL; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Powlson AS; Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Challis BG; Department of Endocrinology, University College London Hospitals NHS Foundation Trust, London, UK.
  • Bashari WA; Department of Endocrinology, University College London Hospitals NHS Foundation Trust, London, UK.
  • Stokes VJ; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Masterson L; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Jani P; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Fish B; Cambridge Endocrine Molecular Imaging Group, Metabolic Research Laboratories, Wellcome-MRC Institute of Metabolic Science, University of Cambridge and National Institute for Health Research Cambridge Biomedical Research Centre, Addenbrooke's Hospital, Cambridge Biomedical Campus, Cambridge, UK.
  • Gurnell M; Department of ENT/Head and Neck Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
  • Casey RT; Department of ENT/Head and Neck Surgery, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Clin Endocrinol (Oxf) ; 99(3): 233-245, 2023 09.
Article in En | MEDLINE | ID: mdl-37272391
ABSTRACT

OBJECTIVE:

Primary hyperparathyroidism is a common endocrine disorder, with 80% of all cases usually caused by one single hyperfunctioning parathyroid adenoma. Conventional imaging modalities for the diagnostic work-up of primary hyperparathyroidism (PHPT) include ultrasound of the neck, 99mTc-sestamibi scintigraphy, and four-dimensional computed tomography (4D-CT). However, the role of other imaging modalities, such as 11C-methionine PET/CT, in the care pathway for PHPT is currently unclear. Here, we report our experience of the diagnostic utility of 11C-methionine PET/CT in a single-center patient cohort (n = 45).

DESIGN:

Retrospective single-center cohort study. PATIENTS AND MEASUREMENTS The data of eligible patients that underwent 11C-methionine PET/CT between 2014 and 2022 at Addenbrooke's Hospital (Cambridge, UK) were collected and analyzed. The clinical utility of imaging modalities was determined by comparing the imaging result with histopathological and biochemical outcomes following surgery.

RESULTS:

In patients with persistent primary hyperparathyroidism following previous surgery, 11C-methionine PET/CT identified a candidate lesion in 6 of 10 patients (60.0%), and histologically confirmed in 5 (50.0%). 11C-methionine PET/CT also correctly identified a parathyroid adenoma in 9 out of 12 patients (75.0%) that failed to be localized on other imaging modalities. 11C-methionine PET/CT had a sensitivity of 70.0% (95% CI 55.8 - 84.2%) for the detection of parathyroid adenomas.

CONCLUSIONS:

This study highlights a diagnostic role for 11C-methionine PET/CT in patients that have undergone unsuccessful prior surgery or have equivocal or negative prior imaging results, aiding localization and a targeted surgical approach.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Parathyroid Neoplasms / Adenoma / Hyperparathyroidism, Primary Type of study: Diagnostic_studies / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Country/Region as subject: Europa Language: En Journal: Clin Endocrinol (Oxf) Year: 2023 Type: Article Affiliation country: United kingdom
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Parathyroid Neoplasms / Adenoma / Hyperparathyroidism, Primary Type of study: Diagnostic_studies / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Humans Country/Region as subject: Europa Language: En Journal: Clin Endocrinol (Oxf) Year: 2023 Type: Article Affiliation country: United kingdom