Skip to main content
Erschienen in:

07.12.2023 | Original Article

Performance of [18F]fluorocholine PET/CT in MEN1-related primary hyperparathyroidism before initial surgery or for persistent/recurrent disease

verfasst von: Aymeric Boucher, Julia Delabie, Charlotte Lussey-Lepoutre, Magalie Haissaguerre, Eric Ouvrard, Vija Lavinia, Maëlle Le Bras, Marie Batisse-Lignier, Thomas Cuny, Nicolas Jacquet-Francillon, Sébastien Gaujoux, Océane Molina, Alessio Imperiale, Adrien Latge, Catherine Ansquer, Antony Kelly, Françoise Borson-Chazot, Ghoufrane Tlili, Frédéric Sebag, Zeinab Hamidou, Pauline Romanet, David Taïeb

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 5/2024

Einloggen, um Zugang zu erhalten

Abstract

Purpose

The aims of the study were to evaluate the performance and robustness of [18F]fluorocholine PET/CT in detecting hyperfunctioning parathyroid glands in MEN1-related primary hyperparathyroidism (pHPT) at different stages of their disease.

Methods

Retrospective French multicenter study including patients with MEN1 pHPT who underwent [18F]fluorocholine PET/CT at initial diagnosis or for evaluation of persistent/recurrent disease. PET/CT were independently reviewed by two readers in a blinded manner. The assessment of PET/CT on a per-patient basis was assessed using a comprehensive set of criteria that considered pathological findings or agreement with alternative diagnostic methods in non-operated patients. The secondary objectives included the analysis of the performance of PET/CT at a per-lesion level, with reference to a pathological Gold Standard, and examining its interobserver reproducibility.

Results

A total of 71 MEN1 patients were included (73 PET/CT) in the study. At the per-patient level (entire cohort), [18F]fluorocholine PET/CT sensitivity ranged from 98.5 to 100% among the different readers. An average of 1.77 glands per PET was described, with 2.35 glands at the initial diagnosis (n = 23) and 1.5 in previously operated cases (n = 50). PET/CT detected more lesions than conventional imaging work-up (neck ultrasound and/or scintigraphy). At the per-lesion level (41 operated patients), sensitivity ranged across different readers from 84.4 to 87%, and specificity ranged from 94.7 to 98.8%. At initial diagnosis, all patients that exhibited 3 or more abnormal glands on PET underwent subtotal parathyroidectomy while 7 out of 13 patients with 1 or 2 gland abnormalities on PET underwent less than subtotal parathyroidectomy. Finally, the degree of inter-observer agreement was high.

Conclusion

[18F]fluorocholine PET/CT is a reliable and robust imaging modality for the evaluation of MEN1-related pHPT and could guide surgeons in achieving the optimal benefit-risk ratio. This study gives a great impetus for its adoption as a primary diagnostic tool in this context.
Anhänge
Nur mit Berechtigung zugänglich
Literatur
3.
Zurück zum Zitat Vinault S, Mariet AS, Le Bras M, Mirallie E, Cardot-Bauters C, Pattou F, et al. Metastatic potential and survival of duodenal and pancreatic tumors in multiple endocrine neoplasia type 1: a GTE and AFCE cohort study (Groupe d’etude des Tumeurs Endocrines and Association Francophone de Chirurgie Endocrinienne). Ann Surg. 2020;272:1094–101. https://doi.org/10.1097/SLA.0000000000003162.CrossRefPubMed Vinault S, Mariet AS, Le Bras M, Mirallie E, Cardot-Bauters C, Pattou F, et al. Metastatic potential and survival of duodenal and pancreatic tumors in multiple endocrine neoplasia type 1: a GTE and AFCE cohort study (Groupe d’etude des Tumeurs Endocrines and Association Francophone de Chirurgie Endocrinienne). Ann Surg. 2020;272:1094–101. https://​doi.​org/​10.​1097/​SLA.​0000000000003162​.CrossRefPubMed
4.
Zurück zum Zitat Ito T, Igarashi H, Uehara H, Berna MJ, Jensen RT. Causes of death and prognostic factors in multiple endocrine neoplasia type 1: a prospective study: comparison of 106 MEN1/Zollinger-Ellison syndrome patients with 1613 literature MEN1 patients with or without pancreatic endocrine tumors. Medicine (Baltimore). 2013;92:135–81. https://doi.org/10.1097/MD.0b013e3182954af1.CrossRefPubMed Ito T, Igarashi H, Uehara H, Berna MJ, Jensen RT. Causes of death and prognostic factors in multiple endocrine neoplasia type 1: a prospective study: comparison of 106 MEN1/Zollinger-Ellison syndrome patients with 1613 literature MEN1 patients with or without pancreatic endocrine tumors. Medicine (Baltimore). 2013;92:135–81. https://​doi.​org/​10.​1097/​MD.​0b013e3182954af1​.CrossRefPubMed
10.
Zurück zum Zitat Santucci N, Ksiazek E, Pattou F, Baud G, Mirallie E, Frey S, et al. Recurrence after surgery for primary hyperparathyroidism in 517 patients with multiple endocrine neoplasia type 1. An AFCE and GTE study (Association Francophone de Chirurgie Endocrinienne and Groupe d'etude des Tumeurs Endocrines). Ann Surg. 2023. https://doi.org/10.1097/SLA.0000000000005980. Santucci N, Ksiazek E, Pattou F, Baud G, Mirallie E, Frey S, et al. Recurrence after surgery for primary hyperparathyroidism in 517 patients with multiple endocrine neoplasia type 1. An AFCE and GTE study (Association Francophone de Chirurgie Endocrinienne and Groupe d'etude des Tumeurs Endocrines). Ann Surg. 2023. https://​doi.​org/​10.​1097/​SLA.​0000000000005980​.
14.
21.
Metadaten
Titel
Performance of [18F]fluorocholine PET/CT in MEN1-related primary hyperparathyroidism before initial surgery or for persistent/recurrent disease
verfasst von
Aymeric Boucher
Julia Delabie
Charlotte Lussey-Lepoutre
Magalie Haissaguerre
Eric Ouvrard
Vija Lavinia
Maëlle Le Bras
Marie Batisse-Lignier
Thomas Cuny
Nicolas Jacquet-Francillon
Sébastien Gaujoux
Océane Molina
Alessio Imperiale
Adrien Latge
Catherine Ansquer
Antony Kelly
Françoise Borson-Chazot
Ghoufrane Tlili
Frédéric Sebag
Zeinab Hamidou
Pauline Romanet
David Taïeb
Publikationsdatum
07.12.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 5/2024
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-023-06537-1