Choline-PET/CT best preoperative imaging tool for localization of hyperparathyroidism: Study
South Korea: Choline PET-CT is the best preoperative imaging tool for the localization of primary hyperparathyroidism, according to a recent study in the journal JAMA Otolaryngology -- Head and Neck Surgery.
Primary hyperparathyroidism is one of the most common hormonal disorders, with women affected three to four times more often than men. Surgical resection of abnormal glands is the mainstay for curative treatment.
Accurate localization of primary hyperparathyroidism (pHPT) before surgery is an important and challenging issue for a successful parathyroidectomy. Although during the past decade, new imaging modalities have been introduced there is a lack of direct comparative studies on advanced imaging techniques. To fill this knowledge gap, Sang-Woo Lee, Kyungpook National University, Daegu, South Korea, and colleagues aimed to compare the performance of different preoperative imaging modalities for the localization of pHPT by performing a network meta-analysis (NMA).
For this purpose, the researchers searched the online databases from the earliest available indexing date through September 28, 2020. The inclusion criteria were diagnostic tests with sensitivities of 2 or more different preoperative imaging modalities for the same individuals.
The meta-analysis included a total of 8495 patients from 119 direct comparative studies using 2 or more imaging modalities for localization of pHPT.
Key findings of the study include:
· The sensitivity of choline positron emission tomography and computed tomography (PET-CT) was significantly higher than that of technetium 99m sestamibi single-photon emission computed tomography (MIBI SPECT) in both patient-based and lesion-based analyses (patient-based analysis: odds ratio, 5.22; lesion-based analysis: odds ratio, 17.70).
· Among 8 representative imaging modality categories, choline PET-CT showed the highest SUCRA value in both patient-based and lesion-based analyses.
· In patient-based analysis after 2010, choline PET-CT showed the highest SUCRA value, followed by the CT category, although MIBI SPECT had the highest SUCRA value in analysis before 2009.
"The results from this network meta-analysis suggest that choline PET-CT showed the best performance in both patient-based and lesion-based analyses and that choline PET-CT would be the best preoperative imaging modality for localization of pHPT," concluded the authors.
Reference:
The study titled, "Direct Comparison of Preoperative Imaging Modalities for Localization of Primary Hyperparathyroidism: A Systematic Review and Network Meta-analysis," is published in the journal JAMA Otolaryngology -- Head and Neck Surgery.
DOI: https://jamanetwork.com/journals/jamaotolaryngology/article-abstract/2780789
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