Is C-11 Methionine PET/CT Able to Localise Sestamibi-Negative Parathyroid Adenomas?
Is C-11 Methionine PET/CT Able to Localise Sestamibi-Negative Parathyroid Adenomas?
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DOI：
10.1007/s00268-016-3795-4
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发表时间：
2017-04-01
影响因子：
2.6
通讯作者：
Luster, Markus
中科院分区：
文献类型：
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作者：
Weber, Theresia;Gottstein, Martin;Luster, Markus
原发性甲状旁腺功能亢进（pHPT）和术前Tc-99司他米比（MIBI）放射造影阴性的患者被认为具有更高的持续性疾病风险。本研究的目的是评估是否额外的成像与C-11甲硫氨酸正电子发射断层扫描/计算机断层扫描（Met-PET/CT）是能够本地化sestamibi阴性功能亢进的甲状旁腺在50例（38名女性，12名男性，年龄13-81岁）pHPT和阴性定位程序，如超声和sestamibi，甲状旁腺手术前进行了Met-PET/CT。前瞻性分析Met-PET/CT结果，并与术中和组织病理学结果进行比较。22%的患者既往接受过甲状旁腺和/或甲状腺手术。Met-PET/CT在45例pHPT患者中准确定位了33例（73%）单腺体腺瘤。在5例多腺体疾病患者中，Met-PET/CT在4例患者（80%）中检测到至少一个功能亢进的甲状旁腺。双腺瘤3例，6个甲状旁腺中5个定位正确。总体而言，57个功能亢进腺体中有40个（70%）通过Met-PET/CT确定。Met-PET/CT在50例患者中有12例（24%）为假阴性，仅1例（2%）为假阳性。术后，50例患者中有48例（96%）治愈。额外的介入前Met-PET/CT成像能够识别74%的pHPT和阴性sestamibi扫描患者的甲状旁腺功能亢进，从而使甲状旁腺手术成功。
Patients with primary hyperparathyroidism (pHPT) and a negative preoperative Tc-99 sestamibi (MIBI) scintigraphy are considered to have a higher risk of persistent disease. The aim of this study was to assess whether additional imaging with C-11 methionine positron emission tomography/computed tomography (Met-PET/CT) is able to localise sestamibi-negative hyperfunctioning parathyroid glands.In 50 patients (38 females, 12 males, age 13-81 years) with pHPT and negative localisation procedures such as ultrasound and sestamibi, a Met-PET/CT was performed before parathyroid surgery. The results of Met-PET/CT were analysed prospectively and compared with intraoperative and histopathological findings. 22% of the patients underwent previous parathyroid and/or thyroid surgery.Met-PET/CT correctly located a single-gland adenoma in 33 of 45 (73%) patients with pHPT. In 5 patients with multiglandular disease, Met-PET/CT detected at least one hyperfunctional parathyroid gland in 4 patients (80%). In 3 patients with double adenomas, 5 of 6 parathyroids were correctly located. Overall, 40 of 57 (70%) hyperfunctioning glands were identified with Met-PET/CT. Met-PET/CT was false-negative in 12 of 50 (24%) patients and false-positive in only one case (2%). Postoperatively, 48 of 50 patients (96%) were cured.Additional pre-interventional imaging with Met-PET/CT was able to identify hyperfunctioning parathyroid glands in 74% of patients with pHPT and negative sestamibi scans, thus enabling successful parathyroid surgery.