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11C-Choline PET/CT vs. 99mTc-MIBI/123Iodide Subtraction SPECT/CT for Preoperative Detection of Abnormal Parathyroid Glands in Primary Hyperparathyroidism: A Prospective, Single-Centre Clinical Trial in 60 Patients

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@article{d903a15094e1496291672ab0776e4a35,
title = "11C-Choline PET/CT vs. 99mTc-MIBI/123Iodide Subtraction SPECT/CT for Preoperative Detection of Abnormal Parathyroid Glands in Primary Hyperparathyroidism: A Prospective, Single-Centre Clinical Trial in 60 Patients",
abstract = "BACKGROUND: In patients with primary hyperparathyroidism (PHPT) locating hyperfunctioning glands (HPGs) is crucial when planning minimally invasive surgery. Dual-isotope subtraction scintigraphy with 99mTc-MIBI/123Iodide using SPECT/CT and planar pinhole imaging (Method A) has previously shown a sensitivity >93%. However, the method is costly and time consuming and entails a high radiation dose. 11C-Choline PET/CT (Method B) is an appealing candidate method unencumbered by these disadvantages.METHODS: Sixty patients with newly diagnosed PHPT participated and were scanned using both methods prior to parathyroidectomy. We investigated whether sensitivities of Method A and Method B are similar in a method-to-method comparison when using surgical findings as the true location.RESULTS: At the patient level, sensitivities were (A) 0.98 (95% CI: 0.90-1.00) and (B) 1.00 (95% CI: 0.93-1.00). At the gland level, sensitivities were (A) 0.88 (95% CI: 0.78-0.94) and (B) 0.87 (95% CI: 0.76-0.92). With a non-inferiority margin of ∆ = -0.1, we found a 1-sided p-value < 0.001.CONCLUSION: Our methods comparison study found that sensitivity of Method B was not inferior to Method A. We suggest that 11C-Choline PET/CT is a clinically relevant first-choice candidate for preoperative imaging of PHPT and that Method B can likely replace Method A in the near future.",
keywords = "prospective cohort, primary hyperparathyroidism, method comparison, Choline PET, MIBI-subtraction SPECT, non-inferiority, clinical trial",
author = "Afefah Ismail and Christensen, {Julie Wulf} and Martin Krakauer and S{\o}ndergaard, {Susanne Bonnichsen} and Bo Zerahn and Birte Nygaard and Bennedb{\ae}k, {Finn Noe} and Bent Kristensen and Jensen, {Lars Thorbj{\o}rn}",
year = "2020",
month = nov,
day = "19",
doi = "10.3390/diagnostics10110975",
language = "English",
volume = "10",
journal = "Diagnostics",
issn = "2075-4418",
publisher = "M D P I AG",
number = "11",

}

RIS

TY - JOUR

T1 - 11C-Choline PET/CT vs. 99mTc-MIBI/123Iodide Subtraction SPECT/CT for Preoperative Detection of Abnormal Parathyroid Glands in Primary Hyperparathyroidism

T2 - A Prospective, Single-Centre Clinical Trial in 60 Patients

AU - Ismail, Afefah

AU - Christensen, Julie Wulf

AU - Krakauer, Martin

AU - Søndergaard, Susanne Bonnichsen

AU - Zerahn, Bo

AU - Nygaard, Birte

AU - Bennedbæk, Finn Noe

AU - Kristensen, Bent

AU - Jensen, Lars Thorbjørn

PY - 2020/11/19

Y1 - 2020/11/19

N2 - BACKGROUND: In patients with primary hyperparathyroidism (PHPT) locating hyperfunctioning glands (HPGs) is crucial when planning minimally invasive surgery. Dual-isotope subtraction scintigraphy with 99mTc-MIBI/123Iodide using SPECT/CT and planar pinhole imaging (Method A) has previously shown a sensitivity >93%. However, the method is costly and time consuming and entails a high radiation dose. 11C-Choline PET/CT (Method B) is an appealing candidate method unencumbered by these disadvantages.METHODS: Sixty patients with newly diagnosed PHPT participated and were scanned using both methods prior to parathyroidectomy. We investigated whether sensitivities of Method A and Method B are similar in a method-to-method comparison when using surgical findings as the true location.RESULTS: At the patient level, sensitivities were (A) 0.98 (95% CI: 0.90-1.00) and (B) 1.00 (95% CI: 0.93-1.00). At the gland level, sensitivities were (A) 0.88 (95% CI: 0.78-0.94) and (B) 0.87 (95% CI: 0.76-0.92). With a non-inferiority margin of ∆ = -0.1, we found a 1-sided p-value < 0.001.CONCLUSION: Our methods comparison study found that sensitivity of Method B was not inferior to Method A. We suggest that 11C-Choline PET/CT is a clinically relevant first-choice candidate for preoperative imaging of PHPT and that Method B can likely replace Method A in the near future.

AB - BACKGROUND: In patients with primary hyperparathyroidism (PHPT) locating hyperfunctioning glands (HPGs) is crucial when planning minimally invasive surgery. Dual-isotope subtraction scintigraphy with 99mTc-MIBI/123Iodide using SPECT/CT and planar pinhole imaging (Method A) has previously shown a sensitivity >93%. However, the method is costly and time consuming and entails a high radiation dose. 11C-Choline PET/CT (Method B) is an appealing candidate method unencumbered by these disadvantages.METHODS: Sixty patients with newly diagnosed PHPT participated and were scanned using both methods prior to parathyroidectomy. We investigated whether sensitivities of Method A and Method B are similar in a method-to-method comparison when using surgical findings as the true location.RESULTS: At the patient level, sensitivities were (A) 0.98 (95% CI: 0.90-1.00) and (B) 1.00 (95% CI: 0.93-1.00). At the gland level, sensitivities were (A) 0.88 (95% CI: 0.78-0.94) and (B) 0.87 (95% CI: 0.76-0.92). With a non-inferiority margin of ∆ = -0.1, we found a 1-sided p-value < 0.001.CONCLUSION: Our methods comparison study found that sensitivity of Method B was not inferior to Method A. We suggest that 11C-Choline PET/CT is a clinically relevant first-choice candidate for preoperative imaging of PHPT and that Method B can likely replace Method A in the near future.

KW - prospective cohort

KW - primary hyperparathyroidism

KW - method comparison

KW - Choline PET

KW - MIBI-subtraction SPECT

KW - non-inferiority

KW - clinical trial

U2 - 10.3390/diagnostics10110975

DO - 10.3390/diagnostics10110975

M3 - Journal article

C2 - 33228254

VL - 10

JO - Diagnostics

JF - Diagnostics

SN - 2075-4418

IS - 11

ER -

ID: 61880553