title: The diagnostic value of 11C-methionine PET in hyperparathyroidism with negative 99mTc-MIBI SPECT: a meta-analysis.
abstract: Background 99mTc-sestamibi (MIBI) parathyroid SPECT is generally regarded as the best preoperative localizing method in patients with hyperparathyroidism (HPT). However, 99mTc-MIBI SPECT is false negative in approximately 25% of adenomas. 11C-methionine positron emission tomography (PET) has been used in HPT with negative 99mTc-MIBI SPECT scan results. Purpose To systematically review and conduct a meta-analysis of published data on the performance of 11C-methionine PET in patients with HPT with negative 99mTc-MIBI SPECT. Material and Methods A comprehensive review of the literature was performed. Pooled sensitivity and specificity of 11C-methionine PET in patients with HPT and a negative 99mTc-MIBI SPECT was calculated on a per-patient basis using receiver-operating characteristic (ROC) methodology. Results Nine studies that met all inclusion and exclusion criteria were included into our meta-analysis, comprising a total sample size of 137 patients. Pooled sensitivity and specificity of 11C-methionine PET in patients with HPT with negative or inconclusive 99mTc-MIBI SPECT scans was 86% and 86%, respectively. The area under the ROC curve was 0.87. Conclusion By merit of the high overall sensitivity, specificity, and accuracy, 11C-methionine PET can potentially complement the diagnostic workup of patients with HPT and negative or inconclusive 99mTc-MIBI SPECT. 11C-methionine PET appears to be a promising diagnostic modality in complicated cases with HPT.
authors: 1 Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors: Leilei
authors: L
authors: Yuan
authors: 1 Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors: Jun
authors: J
authors: Liu
authors: 1 Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors: Ying
authors: Y
authors: Kan
authors: 1 Department of Nuclear Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, PR China.
authors: Jigang
authors: J
authors: Yang
authors: 2 Department of Nuclear Medicine, Affiliated Hospital, Medical College of Qingdao University, Qingdao, PR China.
authors: Xufu
authors: X
authors: Wang
mesh_terms: D002250:Carbon Radioisotopes; D006801:Humans; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging*; D008715:Methionine; D010280:Parathyroid Glands / Q000000981:diagnostic imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D017256:Technetium Tc 99m Sestamibi; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D008715:Methionine
keywords: 11C-methionine; 99mTc-MIBI; SPECT; hyperparathyroidism; positron emission tomography (PET)