FCH-PET/Computed Tomography (CT) in Primary Hyperparathyroidism With Discordant/Negative MIBI Scintigraphy and Ultrasonography
Authors' conclusion
This study highlights the contribution of FCH-PET/CT in a well-phenotyped cohort of normocalcemic patients with discordant or negative findings in [99mTc]Tc-sestamibi scintigraphy and ultrasonography. However, negative imaging in nPHPT does not rule out the possibility of surgical cure by an experienced surgeon.
Study context
- Population
- Osteoporotic patients with mild biological PHPT and discordant or negative [99mTc]Tc-sestamibi scintigraphy and US, all undergoing parathyroidectomy; tertiary referral center
- Participants
- 109 patients
- Exposure
- FCH-PET/CT performance across calcium-defined PHPT groups
- HtCan = 32reference
- NtCan = 39
- NiCan = 38
- Outcome
- Sensitivity and specificity of FCH-PET/CT, compared with first-line imaging in normocalcemic primary hyperparathyroidism (nPHPT)
Methodological detailslongitudinal, tertiary referral centre
- Longitudinal
- Tertiary referral centre
Main finding
As reported in the abstract
Sensitivity of FCH-PET/CT
| Group | Value | Sensitivity |
|---|---|---|
| HtCa | 67% | 67% |
| NtCa | 48% | 48% |
| NiCa | 33% | 33% |
Value
HtCa67%
NtCa48%
NiCa33%
Sensitivity
HtCa67%
NtCa48%
NiCa33%
- NtCa vs HtCa: P = 0.05 vs HtCa
- NiCa vs HtCa: P = 0.004 vs HtCa
- Specificity ranged from
- 97% to 99%
Observational data: associations, not effects.
Further findings
FCH-PET/CT positivity in patients with negative conventional imaging
- FCH-PET/CT positive
- 64.3%
- Biochemical resolution after PTX
- 77.8%
Triple negative imaging
- Patients with triple negative imaging
- 20
- PHPT resolution among these
- 85%
Original publication
FCH-PET/CT in Primary Hyperparathyroidism With Discordant/Negative MIBI Scintigraphy and Ultrasonography. J Clin Endocrinol Metab. Published 8 February 2023. doi:10.
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