[18F]Fluorocholine PET/MRI and [18F]Fluorocholine PET/CT as first- and second-line imaging in primary hyperparathyroidism – who takes the lead?

Purpose: Accurate preoperative localization of hyperfunctioning parathyroid glands is essential for enabling a focused surgical approach in patients with primary hyperparathyroidism (pHPT). Our study aims to determine the diagnostic value of 18F-fluorocholine positron emission tomography/magnetic re...

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Publicado en:European Journal of Nuclear Medicine & Molecular Imaging Vol. 52; no. 13; pp. 5165 - 5175
Autores principales: Petranović Ovčariček, Petra, Schaab, Jan, Beintner-Skawran, Stephan, Maurer, Alexander, Rupp, Niels J., Ikenberg, Kristian, Morand, Grégoire B., Mueller, Simon A., Vetter, Diana, Liberini, Virginia, Giovanella, Luca, Huellner, Martin W.
Formato: Journal Article
Publicado: Springer Nature Nov2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2025
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      pub: Springer Nature
      place: New York, New York
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        185518738
        10.1007/s00259-025-07373-1
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        atl: [18F]Fluorocholine PET/MRI and [18F]Fluorocholine PET/CT as first- and second-line imaging in primary hyperparathyroidism – who takes the lead?
      aug:
        au:
          Petranović Ovčariček, Petra
          Schaab, Jan
          Beintner-Skawran, Stephan
          Maurer, Alexander
          Rupp, Niels J.
          Ikenberg, Kristian
          Morand, Grégoire B.
          Mueller, Simon A.
          Vetter, Diana
          Liberini, Virginia
          Giovanella, Luca
          Huellner, Martin W.
        affil: https://ror.org/00r9vb833 Department of Oncology and Nuclear Medicine, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
      sug:
      ab: Purpose: Accurate preoperative localization of hyperfunctioning parathyroid glands is essential for enabling a focused surgical approach in patients with primary hyperparathyroidism (pHPT). Our study aims to determine the diagnostic value of 18F-fluorocholine positron emission tomography/magnetic resonance imaging ([18F]FCH PET/MRI) and [18F]FCH PET/computed tomography (PET/CT) in identifying parathyroid adenomas. Methods: We conducted a retrospective study to assess the diagnostic accuracy of [18F]FCH PET/MRI and [18F]FCH PET/CT as first- and second-line methods for detecting parathyroid adenomas in patients with pHPT. The primary endpoints included patient-based sensitivity, specificity, and positive predictive value (PPV), with intraoperative surgical localization and histopathological analysis serving as reference, i.e., gold standard. Results: The study included 322 patients. A total of 264 patients underwent [18F]FCH PET/MRI, thereof 155 and 109 as a second- and first-line method, respectively. [18F]FCH PET/CT was performed in 58 patients, thereof 44 and 14 in a second- and first-line setting, respectively. Total sensitivity, specificity, PPV, negative predictive value (NPV), and diagnostic accuracy of [18F]FCH PET/MRI were 0.967, 0.818, 0.983, 0.692, and 0.955, respectively, while the same parameters for [18F]FCH PET/CT were 0.980, 0.875, 0.980, 0.875, and 0.966, respectively (all p > 0.05). There was also no difference between the two methods in the first- or second-line imaging scenarios. Conclusion: Both [18F]FCH PET/MRI and [18F]FCH PET/CT are highly accurate imaging modalities for localizing parathyroid adenomas in both first- and second-line settings. They can be regarded as "top-scoring" or "one-stop-shop" techniques for preoperative assessment.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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