用于检测甲状旁腺异常的 18F-氟胆碱-正电子发射断层扫描/计算机断层扫描(FCH PET/CT)成像:适应症、实践、解释和诊断性能。

IF 4.6 2区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Seminars in nuclear medicine Pub Date : 2024-09-20 DOI:10.1053/j.semnuclmed.2024.08.002
Lucia Noskovicova, Sona Balogova, Cyrielle Aveline, Marc Tassart, Jules Zhang-Yin, Khaldoun Kerrou, Ivan Jaksic, Françoise Montravers, Jean-Noël Talbot
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引用次数: 0

摘要

对于计划接受手术治疗的确诊甲状旁腺功能亢进症(HPT)患者,术前影像学检查有助于优化甲状旁腺切除术(PTX)的手术方案,特别是通过选择可以从微创 PTX(MIPTX)中获益的患者。微创甲状旁腺切除术具有缩短手术时间、缩短切口长度和降低手术风险的优点。通过术前定位研究,PTX 的失败率,特别是由于未怀疑的多腺或异位疾病导致的失败率已大大降低。十多年前,首次有报道称,因其他适应症而进行的FCH PET/CT检查意外定位到了异常的甲状旁腺(PT)。从那时起,来自不同系列患者的大量数据一致证实,与其他放射性药物、超声波或4D-CeCT相比,FCH PET/CT在原发性HPT的甲状旁腺功能亢进(HFPTGs)定位方面具有更好的诊断性能(检测异常PT的灵敏度为97%,范围为96%-98%)。FCH PET/CT 在肾性 HPT 中的应用报道较少。文章讨论并总结了HPT患者FCH PET/CT适应症的文献证据、其安全性、FCH PET/CT的实践和FCH PET/CT结果的解读,包括潜在的解读误区和避免误区的技巧。我们 12 年来的实际经验加强了已发表的证据,支持将 FCH PET/CT 作为可选择手术的所有类型 HPT 患者的一线放射性核素成像技术。
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18F-Fluorocholine-Positron Emission Tomography/Computerized Tomography (FCH PET/CT) Imaging for Detecting Abnormal Parathyroid Glands: Indication, Practice, Interpretation and Diagnostic Performance.

In patients with confirmed hyperparathyroidism (HPT) scheduled for surgical treatment, the preoperatory imaging permits to optimize the operatory protocol of parathyroidectomy (PTX), in particular by selecting those patients who can benefit from minimally invasive PTX (MIPTX). The MIPTX has the merit to shorten the operative time, incision length, and to reduce the operatory risks. With preoperative localization studies, the rate of PTX failure, in particular due to nonsuspected multiglandular or ectopic disease, has been profoundly decreased. The first cases of incidental localization of abnormal parathyroid glands (PTs) on FCH PET/CTs performed for another indication were reported more than one decade ago. Since then, significant amount of data from heterogeneous series of patients consistently confirmed better diagnostic performances of FCH PET/CT (sensitivity for detection of abnormal PT 97%, range 96%-98%) in comparison with other radiopharmaceuticals, ultrasonography or 4D-CeCT in localizing hyperfunctioning parathyroid glands (HFPTGs) in case of primary HPT. Utility of FCH PET/CT in case of renal HPT has been reported in fewer series. The article discusses and summarizes the bibliographic evidence on documented indications of FCH PET/CT in patients with HPT, its safety profile, the practice of FCH PET/CT and interpretation of FCH PET/CT findings, including potential interpretation pitfalls and tips to avoid them. Our real-world experience over 12 years reinforces published evidence supporting the use of FCH PET/CT as the first-line radionuclide imaging technique in patients with all types of HPT in whom surgery is an option.

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来源期刊
Seminars in nuclear medicine
Seminars in nuclear medicine 医学-核医学
CiteScore
9.80
自引率
6.10%
发文量
86
审稿时长
14 days
期刊介绍: Seminars in Nuclear Medicine is the leading review journal in nuclear medicine. Each issue brings you expert reviews and commentary on a single topic as selected by the Editors. The journal contains extensive coverage of the field of nuclear medicine, including PET, SPECT, and other molecular imaging studies, and related imaging studies. Full-color illustrations are used throughout to highlight important findings. Seminars is included in PubMed/Medline, Thomson/ISI, and other major scientific indexes.
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