Digital versus analogue PET in parathyroid imaging: comparison of PET metrics and machine learning-based characterisation of hyperfunctioning lesions (the DIGI-PET study).

Purpose: To compare PET-derived metrics between digital and analogue PET/CT in hyperparathyroidism, and to assess whether machine learning (ML) applied to quantitative PET parameters can distinguish parathyroid adenoma (PA) from hyperplasia (PH). Methods: From an initial multi-centre cohort of 179 p...

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Publicado en:European Journal of Nuclear Medicine & Molecular Imaging Vol. 53; no. 3; pp. 2122 - 2131
Autores principales: Filippi, Luca, Bianconi, Francesco, Ferrari, Cristina, Linguanti, Flavia, Battisti, Claudia, Urbano, Nicoletta, Minestrini, Matteo, Messina, Salvatore Gerardo, Buci, Lisa, Baldoncini, Alfonso, Rubini, Giuseppe, Schillaci, Orazio, Palumbo, Barbara
Formato: Journal Article
Publicado: Springer Nature Feb2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Feb2026
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      pub: Springer Nature
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        187454649
        10.1007/s00259-025-07508-4
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        atl: Digital versus analogue PET in parathyroid imaging: comparison of PET metrics and machine learning-based characterisation of hyperfunctioning lesions (the DIGI-PET study).
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          Filippi, Luca
          Bianconi, Francesco
          Ferrari, Cristina
          Linguanti, Flavia
          Battisti, Claudia
          Urbano, Nicoletta
          Minestrini, Matteo
          Messina, Salvatore Gerardo
          Buci, Lisa
          Baldoncini, Alfonso
          Rubini, Giuseppe
          Schillaci, Orazio
          Palumbo, Barbara
        affil: https://ror.org/02p77k626 Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1, 00133, Rome, Italy
      sug:
      ab: Purpose: To compare PET-derived metrics between digital and analogue PET/CT in hyperparathyroidism, and to assess whether machine learning (ML) applied to quantitative PET parameters can distinguish parathyroid adenoma (PA) from hyperplasia (PH). Methods: From an initial multi-centre cohort of 179 patients, 86 were included, comprising 89 PET-positive lesions confirmed histologically (74 PA, 15 PH). Quantitative PET parameters—maximum standardised uptake value (SUVmax), metabolic tumour volume (MTV), target-to-background ratio (TBR), and maximum diameter—along with serum PTH and calcium levels, were compared between digital and analogue PET scanners using the Mann–Whitney U test. Receiver operating characteristic (ROC) analysis identified optimal threshold values. ML models (LASSO, decision tree, Gaussian naïve Bayes) were trained on harmonised quantitative features to distinguish PA from PH. Results: Digital PET detected significantly smaller lesions than analogue PET, in both metabolic volume (1.32 ± 1.39 vs. 2.36 ± 2.01 cc; p < 0.001) and maximum diameter (8.35 ± 4.32 vs. 11.87 ± 5.29 mm; p < 0.001). PA lesions showed significantly higher SUVmax and TBR compared to PH (SUVmax: 8.58 ± 3.70 vs. 5.27 ± 2.34; TBR: 14.67 ± 6.99 vs. 8.82 ± 5.90; both p < 0.001). The optimal thresholds for identifying PA were SUVmax > 5.89 and TBR > 11.5. The best ML model (LASSO) achieved an AUC of 0.811, with 79.7% accuracy and balanced sensitivity and specificity. Conclusions: Digital PET outperforms analogue system in detecting small parathyroid lesions. Additionally, ML analysis of PET-derived metrics and PTH may support non-invasive distinction between adenoma and hyperplasia.
      pubtype: Academic Journal
      doctype: Journal Article
      ougenre: Article
    language: English
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