■[18F]除了[99mTc]Tc-Sestamibi闪烁显像和超声检查外,还经常使用氟胆碱正电子发射断层扫描/计算机断层扫描(PET/CT)来定位功能亢进的甲状旁腺。这项研究的目的是评估[18F]氟胆碱PET/CT中定量标准的性能,以定位功能亢进的甲状旁腺。次要目标是强调[18F]氟胆碱PET/CT的检出率与血清甲状旁腺激素(PTH)水平之间的相关性。
■在两个学术中心,我们回顾性纳入了患有生物性甲状旁腺功能亢进(HPT)且接受[18F]氟胆碱PET/CT检查的患者.经过视觉分析,为了测量[18F]氟胆碱PET/CT的整体性能,使用最大标准化摄取值(SUVmax)的标准化测量进行盲读,肝脏比率,甲状腺比率,和尺寸比。我们分析了[18F]氟胆碱PET/CT的定量标准与组织学结果相比,特别是为了确定腺瘤和增生之间的差异。我们将每个定量标准的性能与总体灵敏度进行了比较,特异性,阳性预测值(PPV),负预测值(NPV),[18F]氟胆碱PET/CT的准确性。计算血清PTH水平亚组中甲状旁腺功能亢进的检出率。
■测量了120例患者(135个病灶)的[18F]氟胆碱PET/CT的定量标准。代表SUVmax和肝脏比率的受试者工作特征(ROC)曲线下的面积显着增加。最大Youden指数表示的最佳临界值对于SUVmax>4.12,对于肝脏比率>27.4。超过一定阈值的SUVmax(>4.12)或肝脏比率(>38.1),所有病变均为组织学证实的腺瘤.腺瘤的SUVmax和肝脏比率明显高于增生和鉴别诊断(p=0.0085和p=0.0002)。[18F]氟胆碱PET/CT阳性与PTH水平相关。检出率分别为55.56、75.56和87.5%,分别,对于血清PTH<70、70至120和>120ng/ml。
■半定量测量(SUVmax和肝脏比率)应被视为解释[18F]氟胆碱PET/CT的附加工具。这些定量参数在识别腺瘤方面具有较低的总体性能但比总体视觉分析具有较高的特异性。高于某些阈值,所有病变都是腺瘤。[18F]氟胆碱PET/CT证实了检测高功能甲状旁腺的优异性能。对于血清PTH水平<70ng/ml,[18F]氟胆碱PET/CT的检出率大大降低。
UNASSIGNED: [18F]Fluorocholine positron emission tomography/computed tomography (PET/CT) is used frequently in addition to [99mTc]Tc-Sestamibi scintigraphy and ultrasonography for the location of hyperfunctioning
parathyroid glands. The aim of this
study is to evaluate the performance of quantitative criteria in [18F]fluorocholine PET/CT for localization of hyperfunctioning
parathyroid glands. The secondary objective is to highlight a correlation between the detection rate of [18F]fluorocholine PET/CT and serum
parathyroid hormone (PTH) level.
UNASSIGNED: In two academic centers, we retrospectively included patients with biological hyperparathyroidism (HPT) and who had [18F]fluorocholine PET/CT. After a visual analysis, to measure the overall performance of [18F]fluorocholine PET/CT, a blind reading was carried out with standardized measurements of maximum standardized uptake value (SUVmax), liver ratio, thyroid ratio, and size ratio. We analyzed the quantitative criteria of [18F]fluorocholine PET/CT compared to the histological results, in particular to identify differences between adenomas and hyperplasias. We compared the performance of each quantitative criterion to the overall sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of [18F]fluorocholine PET/CT. The detection rate of hyperfunctioning
parathyroid glands was calculated in subgroups of serum PTH level.
UNASSIGNED: The quantitative criteria in [18F]fluorocholine PET/CT were measured for 120 patients (135 lesions). The areas under the receiver operating characteristic (ROC) curve representing SUVmax and liver ratio were significantly increased. The optimal cut-off values represented by the maximum Youden index was >4.12 for SUVmax and >27.4 for liver ratio. Beyond certain threshold values of SUVmax (>4.12) or liver ratio (>38.1), all the lesions were histologically proven adenomas. SUVmax and liver ratio were significantly higher for adenomas than for hyperplasias and differential diagnosis (p = 0.0085 and p = 0.0002). The positivity of [18F]fluorocholine PET/CT was correlated with PTH level. Detection rates were 55.56, 75.56, and 87.5%, respectively, for serum PTH < 70, 70 to 120, and >120 ng/ml.
UNASSIGNED: Semi-quantitative measurements (SUVmax and liver ratio) should be considered as additional tools in interpretation of [18F]fluorocholine PET/CT. These quantitative parameters have lower overall performance but higher specificity than overall visual analysis in identifying an adenoma. Above certain threshold values, all lesions are adenomas. [18F]fluorocholine PET/CT confirms excellent performance for the detection of hyperfunctional parathyroids. For serum PTH levels < 70 ng/ml, the detection rate of [18F]fluorocholine PET/CT is strongly decreased.