Publication

Optimization of parathyroid C-11-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism

Noltes, M. E., Kruijff, S., Noordzij, W., Telenga, E. D., Vállez García, D., Trofimiuk-Müldner, M., Opalińska, M., Hubalewska-Dydejczyk, A., Luurtsema, G., Dierckx, R. A. J. O., El Moumni, M., Boellaard, R. & Brouwers, A. H., 31-Jul-2019, In : EJNMMI Research. 9, 1, 10 p., 73.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Noltes, M. E., Kruijff, S., Noordzij, W., Telenga, E. D., Vállez García, D., Trofimiuk-Müldner, M., Opalińska, M., Hubalewska-Dydejczyk, A., Luurtsema, G., Dierckx, R. A. J. O., El Moumni, M., Boellaard, R., & Brouwers, A. H. (2019). Optimization of parathyroid C-11-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism. EJNMMI Research, 9(1), [73]. https://doi.org/10.1186/s13550-019-0534-5

Author

Noltes, Milou E ; Kruijff, Schelto ; Noordzij, Walter ; Telenga, Eef D ; Vállez García, David ; Trofimiuk-Müldner, Malgorzata ; Opalińska, Marta ; Hubalewska-Dydejczyk, Alicja ; Luurtsema, Gert ; Dierckx, Rudi A J O ; El Moumni, Mostafa ; Boellaard, Ronald ; Brouwers, Adrienne H. / Optimization of parathyroid C-11-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism. In: EJNMMI Research. 2019 ; Vol. 9, No. 1.

Harvard

Noltes, ME, Kruijff, S, Noordzij, W, Telenga, ED, Vállez García, D, Trofimiuk-Müldner, M, Opalińska, M, Hubalewska-Dydejczyk, A, Luurtsema, G, Dierckx, RAJO, El Moumni, M, Boellaard, R & Brouwers, AH 2019, 'Optimization of parathyroid C-11-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism', EJNMMI Research, vol. 9, no. 1, 73. https://doi.org/10.1186/s13550-019-0534-5

Standard

Optimization of parathyroid C-11-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism. / Noltes, Milou E; Kruijff, Schelto; Noordzij, Walter; Telenga, Eef D; Vállez García, David; Trofimiuk-Müldner, Malgorzata; Opalińska, Marta; Hubalewska-Dydejczyk, Alicja; Luurtsema, Gert; Dierckx, Rudi A J O; El Moumni, Mostafa; Boellaard, Ronald; Brouwers, Adrienne H.

In: EJNMMI Research, Vol. 9, No. 1, 73, 31.07.2019.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Noltes ME, Kruijff S, Noordzij W, Telenga ED, Vállez García D, Trofimiuk-Müldner M et al. Optimization of parathyroid C-11-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism. EJNMMI Research. 2019 Jul 31;9(1). 73. https://doi.org/10.1186/s13550-019-0534-5


BibTeX

@article{9888cf8204694d5cb6f92a0b0f714353,
title = "Optimization of parathyroid C-11-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism",
abstract = "PURPOSE: To evaluate the optimal tracer uptake time, the minimal amount of radioactivity and the inter-observer agreement for 11C-choline positron emission tomography/computed tomography (PET/CT) in patients with primary hyperparathyroidism (pHPT).METHODS: Twenty-one patients with biochemically proven pHPT were retrospectively studied after injection of 6.3 ± 1.2 MBq/kg 11C-choline. PET data of the first nine patients, scanned for up to 60 min, were reconstructed in 10-min frames from 10- to 60-min postinjection (p.i.), mimicking varying 11C-choline uptake times. Parathyroid adenoma to background contrast ratios were calculated and compared, using standardized uptake values (SUVs). Data was reconstructed with varying scan durations (1, 2.5, 5, and 10 min) at 20-30-min p.i. (established optimal uptake time), mimicking less administered radioactivity. To establish the minimal required radioactivity, the SUVs in the shorter scan durations (1, 2.5, and 5 min) were compared to the 10-min scan duration to determine whether increased variability and/or statistical differences were observed. Four observers analyzed the 11C-choline PET/CT in four randomized rounds for all patients.RESULTS: SUVpeak of the adenoma decreased from 30 to 40 p.i. onwards. All adenoma/background contrast ratios did not differ from 20- to 30-min p.i. onwards. The SUVs of adenoma in the scan duration of 1, 2.5, and 5 min all differed significantly from the same SUV in the 10-min scan duration (all p = 0.012). However, the difference in absolute SUV adenoma values was well below 10% and therefore not considered clinically significant. The inter-observer analysis showed that the Fleiss' kappa of the 1-min scan were classified as {"}moderate,{"} while these values were classified as {"}good{"} in the 2.5-, 5-, and 10-min scan duration. Observers scored lower certainty scores in the 1- and 2.5-min scans compared to the 5- and 10-min scan durations.CONCLUSION: The optimal time to start PET/CT scanning in patients with pHPT is 20 min after mean injection of 6.3 MBq/kg 11C-choline, with a recommended scan duration of at least 5 min. Alternatively, the radioactivity dose can be lowered by 50% while keeping a 10-min scan duration without losing the accuracy of 11C-choline PET/CT interpretation.",
keywords = "Primary hyperparathyroidism, C-11-Choline PET, Inter-observer agreement, Scan protocol, FDG PET/CT, GUIDELINES, ULTRASOUND",
author = "Noltes, {Milou E} and Schelto Kruijff and Walter Noordzij and Telenga, {Eef D} and {V{\'a}llez Garc{\'i}a}, David and Malgorzata Trofimiuk-M{\"u}ldner and Marta Opali{\'n}ska and Alicja Hubalewska-Dydejczyk and Gert Luurtsema and Dierckx, {Rudi A J O} and {El Moumni}, Mostafa and Ronald Boellaard and Brouwers, {Adrienne H}",
year = "2019",
month = jul,
day = "31",
doi = "10.1186/s13550-019-0534-5",
language = "English",
volume = "9",
journal = "EJNMMI Research",
issn = "2191-219X",
publisher = "SpringerOpen",
number = "1",
note = "31st Annual Congress of the European-Association-of-Nuclear-Medicine (EANM) ; Conference date: 13-10-2018 Through 17-10-2018",

}

RIS

TY - JOUR

T1 - Optimization of parathyroid C-11-choline PET protocol for localization of parathyroid adenomas in patients with primary hyperparathyroidism

AU - Noltes, Milou E

AU - Kruijff, Schelto

AU - Noordzij, Walter

AU - Telenga, Eef D

AU - Vállez García, David

AU - Trofimiuk-Müldner, Malgorzata

AU - Opalińska, Marta

AU - Hubalewska-Dydejczyk, Alicja

AU - Luurtsema, Gert

AU - Dierckx, Rudi A J O

AU - El Moumni, Mostafa

AU - Boellaard, Ronald

AU - Brouwers, Adrienne H

PY - 2019/7/31

Y1 - 2019/7/31

N2 - PURPOSE: To evaluate the optimal tracer uptake time, the minimal amount of radioactivity and the inter-observer agreement for 11C-choline positron emission tomography/computed tomography (PET/CT) in patients with primary hyperparathyroidism (pHPT).METHODS: Twenty-one patients with biochemically proven pHPT were retrospectively studied after injection of 6.3 ± 1.2 MBq/kg 11C-choline. PET data of the first nine patients, scanned for up to 60 min, were reconstructed in 10-min frames from 10- to 60-min postinjection (p.i.), mimicking varying 11C-choline uptake times. Parathyroid adenoma to background contrast ratios were calculated and compared, using standardized uptake values (SUVs). Data was reconstructed with varying scan durations (1, 2.5, 5, and 10 min) at 20-30-min p.i. (established optimal uptake time), mimicking less administered radioactivity. To establish the minimal required radioactivity, the SUVs in the shorter scan durations (1, 2.5, and 5 min) were compared to the 10-min scan duration to determine whether increased variability and/or statistical differences were observed. Four observers analyzed the 11C-choline PET/CT in four randomized rounds for all patients.RESULTS: SUVpeak of the adenoma decreased from 30 to 40 p.i. onwards. All adenoma/background contrast ratios did not differ from 20- to 30-min p.i. onwards. The SUVs of adenoma in the scan duration of 1, 2.5, and 5 min all differed significantly from the same SUV in the 10-min scan duration (all p = 0.012). However, the difference in absolute SUV adenoma values was well below 10% and therefore not considered clinically significant. The inter-observer analysis showed that the Fleiss' kappa of the 1-min scan were classified as "moderate," while these values were classified as "good" in the 2.5-, 5-, and 10-min scan duration. Observers scored lower certainty scores in the 1- and 2.5-min scans compared to the 5- and 10-min scan durations.CONCLUSION: The optimal time to start PET/CT scanning in patients with pHPT is 20 min after mean injection of 6.3 MBq/kg 11C-choline, with a recommended scan duration of at least 5 min. Alternatively, the radioactivity dose can be lowered by 50% while keeping a 10-min scan duration without losing the accuracy of 11C-choline PET/CT interpretation.

AB - PURPOSE: To evaluate the optimal tracer uptake time, the minimal amount of radioactivity and the inter-observer agreement for 11C-choline positron emission tomography/computed tomography (PET/CT) in patients with primary hyperparathyroidism (pHPT).METHODS: Twenty-one patients with biochemically proven pHPT were retrospectively studied after injection of 6.3 ± 1.2 MBq/kg 11C-choline. PET data of the first nine patients, scanned for up to 60 min, were reconstructed in 10-min frames from 10- to 60-min postinjection (p.i.), mimicking varying 11C-choline uptake times. Parathyroid adenoma to background contrast ratios were calculated and compared, using standardized uptake values (SUVs). Data was reconstructed with varying scan durations (1, 2.5, 5, and 10 min) at 20-30-min p.i. (established optimal uptake time), mimicking less administered radioactivity. To establish the minimal required radioactivity, the SUVs in the shorter scan durations (1, 2.5, and 5 min) were compared to the 10-min scan duration to determine whether increased variability and/or statistical differences were observed. Four observers analyzed the 11C-choline PET/CT in four randomized rounds for all patients.RESULTS: SUVpeak of the adenoma decreased from 30 to 40 p.i. onwards. All adenoma/background contrast ratios did not differ from 20- to 30-min p.i. onwards. The SUVs of adenoma in the scan duration of 1, 2.5, and 5 min all differed significantly from the same SUV in the 10-min scan duration (all p = 0.012). However, the difference in absolute SUV adenoma values was well below 10% and therefore not considered clinically significant. The inter-observer analysis showed that the Fleiss' kappa of the 1-min scan were classified as "moderate," while these values were classified as "good" in the 2.5-, 5-, and 10-min scan duration. Observers scored lower certainty scores in the 1- and 2.5-min scans compared to the 5- and 10-min scan durations.CONCLUSION: The optimal time to start PET/CT scanning in patients with pHPT is 20 min after mean injection of 6.3 MBq/kg 11C-choline, with a recommended scan duration of at least 5 min. Alternatively, the radioactivity dose can be lowered by 50% while keeping a 10-min scan duration without losing the accuracy of 11C-choline PET/CT interpretation.

KW - Primary hyperparathyroidism

KW - C-11-Choline PET

KW - Inter-observer agreement

KW - Scan protocol

KW - FDG PET/CT

KW - GUIDELINES

KW - ULTRASOUND

U2 - 10.1186/s13550-019-0534-5

DO - 10.1186/s13550-019-0534-5

M3 - Article

C2 - 31367792

VL - 9

JO - EJNMMI Research

JF - EJNMMI Research

SN - 2191-219X

IS - 1

M1 - 73

T2 - 31st Annual Congress of the European-Association-of-Nuclear-Medicine (EANM)

Y2 - 13 October 2018 through 17 October 2018

ER -

ID: 93414835