Abstract

Minimally invasive parathyroidectomy is the treatment of choice in patients with primary hyperparathyroidism (PHP), but it needs a reliable preoperative localization method to detect hyperfunctioning parathyroid tissue. Higher sensitivity and lower radiation exposure was demonstrated for [18F]fluorocholine PET/CT (FCh-PET/CT) in comparison to [99mTc]sestamibi (MIBI) scintigraphy. However, data of its efficiency in resource use and patient outcomes is lacking. The aim of our study was to determine the resource efficiency and patient outcomes of FCh-PET/CT in comparison to conventional MIBI scintigraphy.

A group of 234 patients who underwent surgery after MIBI scintigraphy was compared to a group of 163 patients who underwent surgery after FCh-PET/CT. The whole working process from the implementation of imaging to the completion of surgical treatment was analyzed. The economic burden was expressed in the time needed for the required procedures.

The time needed to perform imaging was reduced by 83% after FCh-PET/CT in comparison to MIBI scintigraphy. The time needed to perform surgery was reduced by 41% when intraoperative parathyroid hormone monitoring was not used. There was no significant difference in the time of surgery between FCh-PET/CT and MIBI scintigraphy.

FCh-PET/CT reduces the time of imaging, the time of surgery and potentially reduces the number of reoperations for persistent disease.

Details

Title
[18F]fluorocholine PET vs. [99mTc]sestamibi scintigraphy for detection and localization of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: outcomes and resource efficiency
Author
Rep, Sebastijan 1 ; Sirca, Klara 2 ; Ema Macek Lezaic 3 ; Zaletel, Katja 4 ; Hocevar, Marko 5 ; Lezaic, Luka 4 

 Division of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Medical Imaging and Radiotherapy Department, Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia 
 Department of Oncological Surgery, Institute of Oncology Ljubljana, Ljubljana, Slovenia 
 Charité Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany 
 Division of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia 
 Department of Oncological Surgery, Institute of Oncology Ljubljana, Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia 
Pages
486-493
Publication year
2024
Publication date
2024
Publisher
De Gruyter Poland
ISSN
13182099
e-ISSN
0485893X
Source type
Scholarly Journal
Language of publication
English; Slovenian
ProQuest document ID
3133759594
Copyright
© 2024. This work is published under http://creativecommons.org/licenses/by/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.