11С-methionine PET/CT use in the diagnosis of primary hyperparathyroisis

Abstract

Background. Primary hyperparathyroidism (PHPT) is an endocrine disorder characterized by autonomous production of parathyroid hormone (PTH). Currently, parathyroidectomy (PTX) is considered the main method of PHPT treatment. Its outcome is largely depended on precise preoperative localization of the parathyroid adenoma. Traditional visualization techniques include ultrasound (US), scintigraphy and computed tomography (CT), each of which has its own limitations. In order to improve visualization results positron emission tomography/ computed tomography (PET/CT) with 11C-methionine is used. Objective. To compare the sensitivity and specificity of 11 C-methionine PET/CT with those of conventional imaging techniques for parathyroid adenomas localization.Design and methods. The data of 91 patients diagnosed with PHPT was analyzed. Ultrasound, scintigraphy with 99mTc-sestamib i/99mTc-pertechnetate and CT were performed in 91, 56, and 86 patients, respectively. Since 2020, 11C-methionine PET/CT has been used as the final diagnostic method in 45 patients. Histologу results were used as the benchmark in order to evaluate the diagnostic accuracy of the studied methods.Results. Histological examination confirmed parathyroid adenoma/ hyperplasia in all patients. Multiple adenomas/hyperplasia were found in 5 cases. Ectopic adenomas were detected in 19 patients. The sensitivity of PET/CT with 11C-methionine was 98 %, CT, scintigraphy and ultrasound — 75 %, 79 %, 67 %, respectively. Specificity — 93 %, 73 %, 75 %, 70 %, respectively.Conclusion. 11C-methionine PET/CT showed higher sensitivity and specificity than traditional methods.