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Detectability of 18F-choline PET/MR in primary hyperparathyroidism

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Abstract

Purpose

We aimed to evaluate the power of 18F-fluorocholine (FCH) positron emission tomography/magnetic resonance (PET/MR) imaging in unlocalized primary hyperparathyroidism.

Methods

Thirty-four patients were included. In 17/34 patients, PET/MR was performed immediately after a negative 18F-FCH PET/CT. Sensitivity, specificity, positive and negative predictive values were calculated for MR only (blinded to PET data) and PET only (blinded to MR data) findings.

Results

18F-FCH PET/MR was positive in 26/34 (76%) patients. PET/MR was also positive in 12/17 (71%) patients with a negative PET/CT. Among 11/34 (32%) patients where 18F-FCH PET-only and MR-only results were discordant, MR was false positive in 7/11 patients (3/7 of the lesions were not 18F-FCH avid and in 4/7 of them PET and MRI pointed different locations. Postoperative histopathology revealed that 18F-FCH-positive ones were true positives). Sensitivity, specificity, PPV, NPV and accuracy of neck MR evaluated blinded to PET data were 80%, 50%, 70%, 64% and 68%, respectively, and all were calculated as 100% for PET/MR.

Conclusion

18F-FCH PET/MR is very effective in preoperative localization of parathyroid adenomas even if 18F-FCH PET/CT is negative. Neck MR alone is insufficient in detecting parathyroid adenomas but PET/MR combination helps in precise localisation.

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Authors and Affiliations

  1. Nuclear Medicine Department, Cebeci Hospital, Ankara University Medical Faculty, Ankara, Turkey

    Mine Araz, Demet Nak, Çiğdem Soydal & N. Özlem Küçük

  2. Radiology Department, Ankara University Medical School, Ankara, Turkey

    Elif Peker & İlhan Erden

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  1. Mine Araz
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  2. Demet Nak
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  3. Çiğdem Soydal
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  4. Elif Peker
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  5. İlhan Erden
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  6. N. Özlem Küçük
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Araz, M., Nak, D., Soydal, Ç. et al. Detectability of 18F-choline PET/MR in primary hyperparathyroidism. Eur Arch Otorhinolaryngol 279, 2583–2589 (2022). https://doi.org/10.1007/s00405-021-07046-3

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  • DOI: https://doi.org/10.1007/s00405-021-07046-3

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