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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

Sebastijan Rep

Sebastijan Rep

  • Division of Nuclear Medicine, University Medical Centre LjubljanaLjubljana, Slovenia
  • Medical Imaging and Radiotherapy Department, Faculty of Health Sciences, University of LjubljanaLjubljana, Slovenia
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Rep, Sebastijan
, 
Klara Sirca

Klara Sirca

Department of Oncological Surgery, Institute of Oncology LjubljanaLjubljana, Slovenia
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Sirca, Klara
, 
Ema Macek Lezaic

Ema Macek Lezaic

Charité Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, BerlinGermany
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Lezaic, Ema Macek
, 
Katja Zaletel

Katja Zaletel

  • Division of Nuclear Medicine, University Medical Centre LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Zaletel, Katja
, 
Marko Hocevar

Marko Hocevar

  • Department of Oncological Surgery, Institute of Oncology LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Hocevar, Marko
 und 
Luka Lezaic

Luka Lezaic

  • Division of Nuclear Medicine, University Medical Centre LjubljanaLjubljana, Slovenia
  • Faculty of Medicine, University of LjubljanaLjubljana, Slovenia
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Lezaic, Luka
  
28. Nov. 2024
[18F]fluorocholine PET vs. [99mTc]sestamibi scintigraphy for detection and localization of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: outcomes and resource efficiency's Cover Image
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Online veröffentlicht: 28. Nov. 2024
Seitenbereich: 486 - 493
Eingereicht: 06. Sept. 2024
Akzeptiert: 24. Sept. 2024
DOI: https://doi.org/10.2478/raon-2024-0058
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© 2024 Sebastijan Rep et al., published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

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.
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.
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.

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%)**
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