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[18F]fluorocholine PET vs. [99mTc]sestamibi scintigraphy for detection and localization of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: outcomes and resource efficiency Cover

[18F]fluorocholine PET vs. [99mTc]sestamibi scintigraphy for detection and localization of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: outcomes and resource efficiency

Radiology and Oncology
Volume 58 (2024): Issue 4 (December 2024)
By: ,  ,  ,  ,   and    
Open Access
|Nov 2024
Figures & tables

Figures & Tables

TABLE 1.

Workload of the profiles involved in the imaging process

No. workersSS + SPECT (hours)No. patients/dayFCh PET (hours)No. patients/day
Pharmacist13 (12)*12
  RP preparation0.7 (2.8)*0,25
Nurse1
  Cannula placement0.75 (3)*3
  Cannula removal0.3 (1.2)*1,2
Technologist2
  RP application0.75 (3)*1,2
  Imaging time6 (24)*4
  QC dally test0.5 (2)*0,5
Physician1
  PH&CE and writing a report3 (12)*12

* time required for 12 patients to perform SS + SPECT/CT

FCh PET = [18F]fluorocholine positron emission tomography; PH&CE = patient history and clinical examination; RP = radiopharmaceutical; QC = quality control; SS + SPECT/CT = subtraction scintigraphy and single-photon emission tomography/computed tomography

FIGURE 1.

Time workflow/scheme of radiopharmaceutical (RP) application and imaging of subtraction scintigraphy (SS) and single-photon emission tomography/computed tomography (SPECT/CT) in a working day. Approximate times are taken into account for all procedures.

FIGURE 2.

Time workflow/scheme of radiopharmaceutical (RP) application and imaging of [18F]fluorocholine positron emission tomography (FCh-PET) in a working day. Approximate times are taken into account for all procedures.

TABLE 2.

The most common causes (percentages) of postoperative complications

SS and SPECT/CTFCh PET
Tingling4/234 (1.7%)3/163 (1.8%)
Chvostek sign1/234 (0.4%)1/163 (0.6%)
Hungry bone syndrome1/234 (0.4%)2/163 (1.2%)
Malaise1/234 (0.4%)N/C
Hoarseness1/234 (0.4%)N/C
Postoperative Hypocalcemia1/234 (0.4%)N/C
Hematoma1/234 (0.4%)N/C
Deterioration of renal functionN/C1/163 (0.6%)
Reoperation29/234 (12.3%)*3/163 (1.8%)*
All39/234 (16.6%)**10/163 (6.1%)**

* p < 0.001 for SS and SPECT/CT vs. FCh PET;

** p < 0.001 for SS and SPECT/CT vs. FCh PET

FCh PET = [18F]fluorocholine positron emission tomography; N/C = no case; SS and SPECT/CT = subtraction scintigraphy and single-photon emission tomography/computed tomography

TABLE 3.

The patient number and the required time of surgery expressed in minutes after subtraction scintigraphy (SS) and single-photon emission computed tomography/computed tomography (SPECT/CT) vs. [18F]fluorocholine positron emission tomography (FCh-PET)

All ptsMeanMedianSDMinMax
MIBI SS and SPECT/CT23467.3760.0036.8820.00280.00
FCh-PET16370.7955.0038.2125.00195.00
p0.66
Solitary HPGMeanMedianSDMinMax
MIBI SS and SPECT/CT19563.5650.0033.0420.00235.00
FCh-PET13864.4250.0033.0425.00180.00
p0.93
Multiple HPGMeanMedianSDMinMax
MIBI SS and SPECT/CT3994.26100.0043.6525.00235.00
FCh-PET25104.79107.0040.7930.00180.00
p0.23

[i] HPG = hyperfunctioning parathyroid gland(s); Max = maximum; Min = minimum; pts = patients; SD = standard deviation

TABLE 4.

Influence of probable prognostic factors on overall survival (OS) and deasise-free survival (DFS)

All ptsMeanMedianSDMinMax
No ioPTH12360.0050.0033.9125.00195.00
ioPTH39103.00100.0031.2740.00195.00
p< 0.001
Solitary HPGMeanMedianSDMinMax
No ioPTH11357.3050.0031.0525.00180.00
ioPTH2596.6090.0029.7140.00155.00
p< 0.001
Multiple HPGMeanMedianSDMinMax
No ioPTH1085.5570.0049.9030.00195.00
ioPTH15116.33110.0030.4980.00195.00
p0.03

[i] HPG = hyperfunctioning parathyroid gland(s); ioPTH = intraoperative parathyroid hormone determination; Max = maximum; Min = minimum; pts = patients; SD = standard deviation

DOI: https://doi.org/10.2478/raon-2024-0058 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Journal RSS Feed
Language: English
Page range: 486 - 493
Submitted on: Sep 6, 2024
Accepted on: Sep 24, 2024
Published on: Nov 28, 2024
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 issues per year
Keywords:
hyperparathyroidism,
surgery,
parathyroidectomy,
cost-effectiveness,
[18F]choline,
[99mTc]sestamibi,
PET/CT,
SPECT/CT
Related subjects:
Medicine,
Clinical medicine,
Radiology

© 2024 Sebastijan Rep, Klara Sirca, Ema Macek Lezaic, Katja Zaletel, Marko Hocevar, Luka Lezaic, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 58 (2024): Issue 4 (December 2024)
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