![[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](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6748c30a8b676d152c205b45/cover-image.jpg)
FIGURE 1.
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.](https://sciendo-parsed.s3.eu-central-1.amazonaws.com/6748c30a8b676d152c205b45/j_raon-2024-0058_fig_002.jpg?X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Content-Sha256=UNSIGNED-PAYLOAD&X-Amz-Credential=ASIA6AP2G7AKBXMRUHLN%2F20260305%2Feu-central-1%2Fs3%2Faws4_request&X-Amz-Date=20260305T082626Z&X-Amz-Expires=3600&X-Amz-Security-Token=IQoJb3JpZ2luX2VjEAAaDGV1LWNlbnRyYWwtMSJIMEYCIQDFYxdKUAYc9NlRI1hb%2FiofOc%2BSDL59IJvJDh8nk7S4xAIhAOWo%2FGEPMCEnypust1PwSVcZPNilT7Cz6PHc2zdmBxLJKsQFCMn%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQAhoMOTYzMTM0Mjg5OTQwIgwnJ45zC3nwUXeNTTMqmAVbXdIDeuXm2UULB6coMp5lFKLlRq2dY2FU045sFc%2BfkmeIVoeOixWGQALh2xYPB1C96eSG3eMu99hEmbtnBirURid4O0hjlGR2X9H1xGVqqYpTU3kt%2B6cqiWS4Pb4onYYvYP0qqFs7YJecHHHt0AwEZC1Cv0Jsz9PY4TyPovsiH8cJOVu1pxndTjqyrXby%2FPckz0euxbQQwujnb40WFEDhkCVd2cBAZtGLCT%2BHj0JtUmBdwpEujzBRxQ2X%2FBGPza0D%2BbSDYr94JmREGZOZWvdmCDP0gMBaXW9rK6%2FPIXxEGbTlQGavVFt3qZX35T3tStHxMr%2FDkw4szlYKRC7dgtmtZHKC%2F%2B%2FZk8VQsIsGcOk6ZSoBeFuuezNUuSxrhZwpo2XbRxdHt%2FDkWijhDoCkHdl48Smp%2F00XbDvGLoskQM43bQcvDo0BcSPQKBJTjXWd5qs50rdSCtgFIn%2FvkJUB3r8x%2BvL6kify%2BWlOrz%2FXbkrYmNgB6jLx0r%2FYvZOLUHqXOh2iFLMgNwg4L2xW9l5vudXbHd7f7kaJIjTftf6pSGM%2BeL9SnNzAdhGxXTP%2FWr08bMwIwjfNBTuEl9xmD8qZMAGCn3VW1ULMx%2FXSMBvkDccXVV3mMXwJ5UFEX2WdY5862bwjQIy7KcCsP17m4pp1dEuRTRwlalzspGowrqBtnNdbGHeOEmW%2Bg%2FaNgFCrIblIyUzsADW%2FbT8eTNDsR3qx486SZ4AhUvZkrFLPwZTiNL%2F6tfoPupbG4jNWs7pUBIYFcFiiy5eo4hv%2FuVkHo2iX6TEi%2BfwEt5rrLbw9LitPIvlfgeUDLwXoScXGT%2FPP0HpISmbs2QuIGofshazYirb9UFXg5VUzwbyeproz0rEw7MPvirwK%2F6AG045xMPbfpM0GOrABnBz0Z8ImOHe2NFSeIciNlUXuX%2BAtwWbqHdtJ0WSQq0pILmdTyaH98oZ35%2BIliDrR5YV%2BsgV%2FQD6ehoDMyxLuKOXqjs1gsyX6O1qk%2BiPqITLnxRVUUs7dE9WkQGrI9dlSui3MfFjEJyyZSTH%2BzM%2B88Ljy3SLW4m01pkAC6eMt2pGkB8ZSODvVh1my5Foli6LnAye%2BlWL8J5Zj6o%2FqrSBA%2BoeRQhr23tchaxVn%2B4Ig8Dw%3D&X-Amz-Signature=7ae2fd011e166282c3407874fb688116d5710cc707126d93326f2b79b98bf96c&X-Amz-SignedHeaders=host&x-amz-checksum-mode=ENABLED&x-id=GetObject)
Workload of the profiles involved in the imaging process
| No. workers | SS + SPECT (hours) | No. patients/day | FCh PET (hours) | No. patients/day | |
|---|---|---|---|---|---|
| Pharmacist | 1 | 3 (12)* | 12 | ||
| RP preparation | 0.7 (2.8)* | 0,25 | |||
| Nurse | 1 | ||||
| Cannula placement | 0.75 (3)* | 3 | |||
| Cannula removal | 0.3 (1.2)* | 1,2 | |||
| Technologist | 2 | ||||
| RP application | 0.75 (3)* | 1,2 | |||
| Imaging time | 6 (24)* | 4 | |||
| QC dally test | 0.5 (2)* | 0,5 | |||
| Physician | 1 | ||||
| PH&CE and writing a report | 3 (12)* | 12 |
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 pts | Mean | Median | SD | Min | Max | |
|---|---|---|---|---|---|---|
| MIBI SS and SPECT/CT | 234 | 67.37 | 60.00 | 36.88 | 20.00 | 280.00 |
| FCh-PET | 163 | 70.79 | 55.00 | 38.21 | 25.00 | 195.00 |
| p | 0.66 | |||||
| Solitary HPG | Mean | Median | SD | Min | Max | |
| MIBI SS and SPECT/CT | 195 | 63.56 | 50.00 | 33.04 | 20.00 | 235.00 |
| FCh-PET | 138 | 64.42 | 50.00 | 33.04 | 25.00 | 180.00 |
| p | 0.93 | |||||
| Multiple HPG | Mean | Median | SD | Min | Max | |
| MIBI SS and SPECT/CT | 39 | 94.26 | 100.00 | 43.65 | 25.00 | 235.00 |
| FCh-PET | 25 | 104.79 | 107.00 | 40.79 | 30.00 | 180.00 |
| p | 0.23 |
Influence of probable prognostic factors on overall survival (OS) and deasise-free survival (DFS)
| All pts | Mean | Median | SD | Min | Max | |
|---|---|---|---|---|---|---|
| No ioPTH | 123 | 60.00 | 50.00 | 33.91 | 25.00 | 195.00 |
| ioPTH | 39 | 103.00 | 100.00 | 31.27 | 40.00 | 195.00 |
| p | < 0.001 | |||||
| Solitary HPG | Mean | Median | SD | Min | Max | |
| No ioPTH | 113 | 57.30 | 50.00 | 31.05 | 25.00 | 180.00 |
| ioPTH | 25 | 96.60 | 90.00 | 29.71 | 40.00 | 155.00 |
| p | < 0.001 | |||||
| Multiple HPG | Mean | Median | SD | Min | Max | |
| No ioPTH | 10 | 85.55 | 70.00 | 49.90 | 30.00 | 195.00 |
| ioPTH | 15 | 116.33 | 110.00 | 30.49 | 80.00 | 195.00 |
| p | 0.03 |
The most common causes (percentages) of postoperative complications
| SS and SPECT/CT | FCh PET | |
|---|---|---|
| Tingling | 4/234 (1.7%) | 3/163 (1.8%) |
| Chvostek sign | 1/234 (0.4%) | 1/163 (0.6%) |
| Hungry bone syndrome | 1/234 (0.4%) | 2/163 (1.2%) |
| Malaise | 1/234 (0.4%) | N/C |
| Hoarseness | 1/234 (0.4%) | N/C |
| Postoperative Hypocalcemia | 1/234 (0.4%) | N/C |
| Hematoma | 1/234 (0.4%) | N/C |
| Deterioration of renal function | N/C | 1/163 (0.6%) |
| Reoperation | 29/234 (12.3%)* | 3/163 (1.8%)* |
| All | 39/234 (16.6%)** | 10/163 (6.1%)** |