Comparison of 99mTc-sestamibi and 11C-methionine PET/CT in the localization of parathyroid adenomas in primary hyperparathyroidism
Comparison of 99mTc-sestamibi and 11C-methionine PET/CT in the localization of parathyroid adenomas in primary hyperparathyroidism
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DOI：
10.1016/j.remn.2013.08.002
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发表时间：
2014-03-01
影响因子：
1.2
通讯作者：
Carril, J. M.
中科院分区：
文献类型：
--
作者：
Martinez-Rodriguez, I.;Martinez-Amador, N.;Carril, J. M.
目的：评价C-11-甲硫氨酸PET/CT(MET)在甲状旁腺腺瘤定位诊断中的应用价值，并与常规双时相~(99m)Tc-Sestamibi显像(MIBI)结果比较。材料与方法：对14例接受手术治疗的原发性甲状旁腺功能亢进(PH)患者进行前瞻性研究，平均年龄65.5±9.7岁。平均血清iPTH为215.8+/-108pg/ml，血钙为10.8+/-0.9mgdL。分别于注射740MBq(20mCI)的Tc99m-Sestamibi后10min和2~3h行MIBI(平面和SPECT)。分别于注射740MBq(20mCi)C-11-蛋氨酸后10min和40min获得MET。对MIBI和MET图像进行视觉评价和比较。结果：14例甲状旁腺腺瘤患者中，11例MIBI与MET检查结果一致，其中10例甲状旁腺腺瘤定位正确。3/14例MIBI阳性，MET阴性(2例MIBI正确定位甲状旁腺腺瘤)。根据MET采集时间的不同，10例患者10分钟和40分钟采集时间相同，3例10分钟采集时间高于10分钟，1例甲状旁腺腺瘤仅在40分钟采集时间显示。结论：MIBI仍是PH患者甲状旁腺腺瘤定位的首选方法。在选定的患者中，MET可能起到补充作用。当早期获取是否定的时，延迟获取应包括在MET协议中。(C)2013年埃尔塞维尔·埃斯帕纳、S.L.和SEMNIM。版权所有。
Aim: To evaluate the usefulness of C-11-methionine PET/CT (MET) in the localization of the parathyroid adenomas and to compare the results with those obtained with the conventional technique in double-phase Tc-99m-sestamibi scintigraphy (MIBI). We evaluated the optimal timing to acquire MET images.Material and methods: A prospective study that included 14 patients (mean age: 65.5 +/- 9.7 years) with primary hyperparathyroidism (PH) who underwent surgery was performed. Mean serum iPTH was 215.8 +/- 108 pg/mL and serum calcium 10.8 +/- 0.9 mg/dL. MIBI (planar and SPECT) was obtained 10 min and 2-3 h after injection of 740 MBq (20 mCi) of Tc-99m-sestamibi. MET was obtained 10 min and 40 min after injection of 740 MBq (20 mCi) of C-11-methionine. MIBI and MET images were visually evaluated and compared. A score for 10 min and 40 min MET images from 0 (no abnormal uptake) to 3 (intense uptake) was assigned.Results: MIBI and MET were positive and concordant in 11/14 patients and in 10 of them the parathyroid adenoma was correctly localized. In 3/14 MIBI was positive and MET negative (MIBI correctly localized the parathyroid adenoma in 2 of them). According to the timing of MET imaging acquisition, the 10 min and 40 min acquisition showed the same score in 10 patients, it was higher at 10 min acquisition in 3 and in 1 the parathyroid adenoma was only detected at 40 min acquisition.Conclusion: MIBI remains the technique of choice for the localization of parathyroid adenomas in patients with PH. MET may play a complementary role in selected patients. Delayed acquisition should be included in the MET protocol when the early acquisition is negative. (C) 2013 Elsevier Espana, S.L. and SEMNIM. All rights reserved.