기존 영상검사에서 음성 혹은 불일치 결과의 원발성 부갑상선 항진증에서의 11C-Methionine PET/CT의 가치 = Value of ¹¹C-Methionine PET/CT in Primary Hyperparathyroidism with Negative or Discordant Conventional Imaging

다국어 초록 (Multilingual Abstract)

Purpose: 11C-Methionine PET/CT is a promising method for detecting parathyroid lesions in patients with primary hyperparathyroidism (PHPT). We aimed to determine the diagnostic ability and correlation of digital 11C-Methionine PET/CT for parathyroid lesions in patients with PHPT, particularly in cases where standard imaging methods yielded inconclusive results. Methods: This retrospective analysis was conducted on patients diagnosed with PHPT who underwent digital 11C-Methionine PET/CT imaging because of ambiguous results on standard imaging work-up (99mTc-MIBI parathyroid scan and/or neck ultrasonography). Quantitative 11C-Methionine PET/CT parameters, including maximum standardized uptake value (SUVmax), mean SUV (SUVmean), peak SUV (SUVpeak), parathyroid methionine volume (PMV), and whole methionine uptake (WMU: PMV multiplied by SUVmean) were calculated with various thresholds, and their correlations with biochemical and pathologic parameters were investigated. Results: This study included 47 consecutive patients (15 men and 32 women) with a median age of 61.0 years. The lesion detection rate of digital ¹¹C-Methionine PET/CT was 76.6% (36/47). Quantitative analysis revealed that serum calcium was significantly correlated with PMV50% (r = 0.550, P = 0.008) and WMU50% (r = 0.431, P = 0.045). Conclusion: Digital 11C-Methionine PET/CT offers good performance in the detection of parathyroid lesions in PHPT patients with inconclusive standard imaging work-up. The volume parameter of PMV50% and WMU50% significantly correlated biochemical parameters and can serve as a complementary diagnostic tool. Keywords: Hyperparathyroidism, Methionine, Positron-Emission Tomography, Parathyroid hormone, Hypercalcemia

목차 (Table of Contents)

• Abstract i
• List of Tables iii
• List of Figures iv
• Introduction 1
• Materials and Methods 3
• Results 5
• Discussion 7
• Conclusion 10
• References 11
• Tables 16
• Figures 22
• 국문요약 25