ArticleEuropean journal of nuclear medicine and molecular imaging2018
F18-choline PET/CT guided surgery in primary hyperparathyroidism when ultrasound and MIBI SPECT/CT are negative or inconclusive: the APACH1 study.
Article in European journal of nuclear medicine and molecular imaging, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02432599 (Interest of the F18-choline as a Second Line of the Tracer for Detection of Parathyroid Adenomas), which is not on this map. Cited by 52 papers, 5 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Interest of the F18-choline as a Second Line of the Tracer for Detection of Parathyroid Adenomas
Who cites it
52 citing papers in PubMed, 5 syntheses or guidelines pooled it, 125 citations in OpenAlex.
- Head-to-head comparison amongEndocrine · 2021Pooled it
- Assessment and Comparison ofJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2021Pooled it
- Pooled it
- Diagnostic performance of choline PET for detection of hyperfunctioning parathyroid glands in hyperparathyroidism: a systematic review and meta-analysis.European journal of nuclear medicine and molecular imaging · 2019Pooled it
- Diagnostic Performance of F-18 Fluorocholine PET/CT for Parathyroid Localization in Hyperparathyroidism: a Systematic Review and Meta-Analysis.Hormones & cancer · 2018Pooled it
- Accuracy ofJournal of nuclear medicine : official publication, Society of Nuclear Medicine · 2021Trial
- Feasibility of Hyperfunctioning Parathyroid Gland Localization Using [Molecular imaging and biology · 2019Trial
- Additional value of integratedEuropean journal of nuclear medicine and molecular imaging · 2019Trial
- Choline PET/CT in the PSMA Era: Clinical Repositioning, Biological Perspectives, and Emerging Applications.Diagnostics (Basel, Switzerland) · 2026Review
- [European journal of nuclear medicine and molecular imaging · 2025Article
- Primary Hyperparathyroidism: 18F-Fluorocholine PET/CT vs. 4D-CT for Parathyroid Identification: Toward a Comprehensive Diagnostic Framework-An Updated Review and Recommendations.Journal of clinical medicine · 2025Review
- Impact of 18F-choline PET-CT or PET-MRI on surgical strategy in patients with primary hyperparathyroidism.BJS open · 2025Article
- Use of choline PET and ultrasound for preoperative localization of hyperfunctioning parathyroid glands: a single-institution retrospective cohort study.Gland surgery · 2025Article
- Article
- Refining the role of presurgical PET/4D-CT in a large series of patients with primary hyperparathyroidism undergoing [European journal of clinical investigation · 2025Article
- Conventional imaging techniques plusFrontiers in endocrinology · 2025Article
- Comparison ofFrontiers in endocrinology · 2025Article
- Article
- Cost-effectiveness of one-stop-shop [European journal of nuclear medicine and molecular imaging · 2024Article
- The role ofGland surgery · 2023Article
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Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the sensitivity of F18-choline (FCH) PET/CT for parathyroid adenoma detection prior to surgery in patients with primary hyperparathyroidism and negative or inconclusive cervical ultrasound and Tc99m-sestaMIBI SPECT/CT.
methodsWe conducted a prospective bicentric study (NCT02432599). All patients underwent FCH PET/CT. The result was scored positive, inconclusive or negative. The number of uptakes and their sites were recorded. The FCH PET/CT result guided the surgical procedure (minimally invasive parathyroidectomy, bilateral cervical exploration, or other in case of multiple or ectopic foci). FCH PET/CT results were compared to the surgical and pathological findings and the follow-up.
resultsTwenty-five patients were included. Mean calcium and PTH levels prior to surgery were 2.76 ± 0.17 mmol/l and 94.8 ± 37.4 ng/l. Nineteen (76%) FCH PET/CTs were scored positive, 3 (12%) inconclusive and 3 (12%) negative, showing 21 cases of uniglandular disease, including 1 ectopic localization and 1 case of multiglandular (3 foci) disease. Mean lesion size was 13.1 ± 8.6 mm. Twenty-four patients underwent surgery. FCH PET/CT guided surgery in 22 (88%) patients, allowing for 17 minimally invasive parathyroidectomies, 1 bilateral cervical exploration for multifocality and 4 other surgical procedures. Two patients with negative FCH-PET/CT underwent bilateral cervical exploration. When dichotomizing the FCH PET/CT results, thereby classifying the inconclusive FCH PET/CT results as positive, the per lesion and per patient sensitivities were 91.3% (95%CI: 72.0-98.9) and 90.5% (95%CI: 69.6-98.8) and the corresponding positive predictive values were 87.5% (95%CI: 67.6-97.3) and 86.4% (95%CI: 65.1-97.1), respectively. Twenty-one (88%) patients were considered cured after surgery. Their mean calcium level after surgery was 2.36 ± 0.17 mmol/l.
conclusionsPreoperative FCH PET/CT has a high sensitivity and positive predictive value for parathyroid adenoma detection in patients with primary hyperparathyroidism and negative or inconclusive conventional imaging results. Bilateral cervical exploration could be avoided in the majority (75%) of patients.
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