ECE2020 Audio ePoster Presentations Hot topics (including COVID-19) (110 abstracts)
18 Flour-Cholin-PET-CTis the supreme tool to localize ultrasound and mibi-’negative’ parathyroid adenomas – intraoperative correlation and 12 month postoperative results
Constantin Smaxwil 1 , Aschoff Philipp 2 , Busch Mirjam 1 , Wagner Joachim 1 , Altmeier Julia 1 , Ploner Oswald 3 & Zielke Andreas 1
1Stuttgart, Endocrine Surgery Diakonieklinikum, Stuttgart, Germany; 2Stuttgart, Nuklearmedizin, Diakonieklinikum, Stuttgart, Germany; 3Endokrinologie, Diakonieklinikum Stuttgart, Stuttgart, Germany
Background: To characterize the diagnostic performance of 18-Fluoroethylcholine-PET-CT (FCH-PET-CT) to localize parathyroid adenomas (PA) in primary hyperparathyroidism (pHPT) when ultrasound (US) and MIBI-Scan (MibiS) fail to localize – intraoperative correlation and one-year follow up.
Method: Beginning in 07/2017 18-FCH-PET was employed in patients with proven pHPT in whom US and MS delivered either incongruent or negative findings. All patients were offered cervical explorations with intraoperative PTH-monitoring (IO-PTH) and subjected to followed up for 12 months postoperatively.
Results: From 07/2017 to 05/2020 432 patients were operated for pHPT (17 redo-for-HPT, 62 with prior surgery to the neck). During this period 173 FCH-Pet-CTs were performed suggesting PA(s) in 162 (94%). 134 of the 173 patients of this cohort already had their surgery, confirming FCH to have accurately localized PA(s) to the respective side of the neck in 131; to have been false neg. in 2 and false pos. in 1, for a global sensitivity of 0.98; accuracy of 0.98 and PPV of 0.99. The 12-month postoperative follow up of the first 95 patients suggested that no PA(s) were missed. One patient with reoperative surgery because of persistent HPT may develop recurrent disease 10 months after surgery.
Conclusion: FCH-PET-CT is a clinically meaningful diagnostic utility when US and MibiS fail to localize a PA. FCH-PET-CT has the potential to replace MibiS. FCH-PET-CT allowes for planned unilateral and focused as opposed to bilateral explorations in almost all of our cases. We, therefore, suggest FCH-PET-CT for the localisation of negative PA(s).
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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