{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T21:32:10Z","timestamp":1789421530194,"version":"build-2803163510"},"reference-count":30,"publisher":"Walter de Gruyter GmbH","issue":"4","license":[{"start":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T00:00:00Z","timestamp":1732752000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Minimally invasive parathyroidectomy is the treatment of choice in patients with primary hyperparathyroidism (PHP), but it needs a reliable preoperative localization method to detect hyperfunctioning parathyroid tissue. Higher sensitivity and lower radiation exposure was demonstrated for [\n                      <jats:sup>18<\/jats:sup>\n                      F]fluorocholine PET\/CT (FCh-PET\/CT) in comparison to [\n                      <jats:sup>99m<\/jats:sup>\n                      Tc]sestamibi (MIBI) scintigraphy. However, data of its efficiency in resource use and patient outcomes is lacking. The aim of our study was to determine the resource efficiency and patient outcomes of FCh-PET\/CT in comparison to conventional MIBI scintigraphy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>A group of 234 patients who underwent surgery after MIBI scintigraphy was compared to a group of 163 patients who underwent surgery after FCh-PET\/CT. The whole working process from the implementation of imaging to the completion of surgical treatment was analyzed. The economic burden was expressed in the time needed for the required procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The time needed to perform imaging was reduced by 83% after FCh-PET\/CT in comparison to MIBI scintigraphy. The time needed to perform surgery was reduced by 41% when intraoperative parathyroid hormone monitoring was not used. There was no significant difference in the time of surgery between FCh-PET\/CT and MIBI scintigraphy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>FCh-PET\/CT reduces the time of imaging, the time of surgery and potentially reduces the number of reoperations for persistent disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2478\/raon-2024-0058","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T15:19:19Z","timestamp":1732807159000},"page":"486-493","source":"Crossref","is-referenced-by-count":9,"title":["[\n                    <sup>18<\/sup>\n                    F]fluorocholine PET\n                    <i>vs<\/i>\n                    . [\n                    <sup>99m<\/sup>\n                    Tc]sestamibi scintigraphy for detection and localization of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism: outcomes and resource efficiency"],"prefix":"10.2478","volume":"58","author":[{"given":"Sebastijan","family":"Rep","sequence":"first","affiliation":[{"name":"Division of Nuclear Medicine , University Medical Centre Ljubljana , Ljubljana , Slovenia"},{"name":"Medical Imaging and Radiotherapy Department, Faculty of Health Sciences , University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klara","family":"Sirca","sequence":"additional","affiliation":[{"name":"Department of Oncological Surgery , Institute of Oncology Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ema Macek","family":"Lezaic","sequence":"additional","affiliation":[{"name":"Charit\u00e9 Universit\u00e4tsmedizin Berlin, Humboldt-Universit\u00e4t zu Berlin , Berlin , Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katja","family":"Zaletel","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine , University Medical Centre Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marko","family":"Hocevar","sequence":"additional","affiliation":[{"name":"Department of Oncological Surgery , Institute of Oncology Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luka","family":"Lezaic","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine , University Medical Centre Ljubljana , Ljubljana , Slovenia"},{"name":"Faculty of Medicine , University of Ljubljana , Ljubljana , Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"2026042912041408825_j_raon-2024-0058_ref_001","doi-asserted-by":"crossref","unstructured":"Bilezikian JP, Bandeira L, Khan A, Cusano NE. Hyperparathyroidism. Lancet 2018; 391: 168\u2013178. doi: 10.1016\/S0140-6736(17)31430-7","DOI":"10.1016\/S0140-6736(17)31430-7"},{"key":"2026042912041408825_j_raon-2024-0058_ref_002","doi-asserted-by":"crossref","unstructured":"Minisola S, Cipriani C, Diacinti D, Tartaglia F, Scillitani A, Pepe J, et al. Imaging of the parathyroid glands in primary hyperparathyroidism. Eur J Endocrinol 2016; 174: D1\u20138. doi: 10.1530\/EJE-15-0565","DOI":"10.1530\/EJE-15-0565"},{"key":"2026042912041408825_j_raon-2024-0058_ref_003","doi-asserted-by":"crossref","unstructured":"Hocevar M, Lezaic L, Rep S, Zaletel K, Kocjan T, Sever MJ, et al. Focused parathyroidectomy without intraoperative parathormone testing is safe after pre-operative localization with 18F-fluorocholine PET\/CT. Eur J Surg Oncol 2017; 43: 133\u20137. doi: 10.1016\/j.ejso.2016.09.016","DOI":"10.1016\/j.ejso.2016.09.016"},{"key":"2026042912041408825_j_raon-2024-0058_ref_004","doi-asserted-by":"crossref","unstructured":"Wong KK, Fig LM, Gross MD, Dwamena BA. Parathyroid adenoma localization with 99mTc-sestamibi SPECT\/CT: a meta-analysis. Nucl Med Commun 2015; 36: 363\u201375. doi: 10.1097\/MNM.0000000000000262","DOI":"10.1097\/MNM.0000000000000262"},{"key":"2026042912041408825_j_raon-2024-0058_ref_005","doi-asserted-by":"crossref","unstructured":"Treglia G, Trimboli P, Huellner M, Giovanella L. Imaging in primary hyperparathyroidism: focus on the evidence-based diagnostic performance of different methods. Minerva Endocrinol 2018; 43: 133\u201343, doi: 10.23736\/S0391-1977.17.02685-2","DOI":"10.23736\/S0391-1977.17.02685-2"},{"key":"2026042912041408825_j_raon-2024-0058_ref_006","doi-asserted-by":"crossref","unstructured":"Petranovi\u0107 Ov\u010dari\u010dek P, Giovanella L, Carri\u00f3 Gasset I, Hindi\u00e9 E, Huellner MW, Luster M, et al. The EANM practice guidelines for parathyroid imaging. Eur J Nucl Med Mol Imaging 2021; 48: 2801\u201322. doi: 10.1007\/s00259-021-05334-y","DOI":"10.1007\/s00259-021-05334-y"},{"key":"2026042912041408825_j_raon-2024-0058_ref_007","doi-asserted-by":"crossref","unstructured":"Lee SW, Shim SR, Jeong SY, Kim SJ. Direct comparison of preoperative imaging modalities for localization of primary hyperparathyroidism: a systematic review and network meta-analysis. JAMA Otolaryngol Head Neck Surg 2021; 147: 692\u2013706. doi: 10.1001\/jamaoto.2021.0915","DOI":"10.1001\/jamaoto.2021.0915"},{"key":"2026042912041408825_j_raon-2024-0058_ref_008","doi-asserted-by":"crossref","unstructured":"Lezaic L, Rep S, Sever MJ, Kocjan T, Hocevar M, Fettich J. 18F-Fluorocholine PET\/CT for localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism: a pilot study. Eur J Nucl Med Mol Imaging 2014; 41: 2083\u20139. doi: 10.1007\/s00259-014-2837-0","DOI":"10.1007\/s00259-014-2837-0"},{"key":"2026042912041408825_j_raon-2024-0058_ref_009","doi-asserted-by":"crossref","unstructured":"Michaud L, Balogova S, Burgess A, Ohnona J, Huchet V, Kerrou K, et al. A pilot comparison of 18F-fluorocholine PET\/CT, ultrasonography and 123I\/99mTc-sestaMIBI dual-phase dual-isotope scintigraphy in the preoperative localization of hyperfunctioning parathyroid glands in primary or secondary hyperparathyroidism: influence of thyroid anomalies. Medicine 2015; 94: e1701. doi: 10.1097\/MD.0000000000001701","DOI":"10.1097\/MD.0000000000001701"},{"key":"2026042912041408825_j_raon-2024-0058_ref_010","doi-asserted-by":"crossref","unstructured":"Thanseer N, Bhadada SK, Sood A, Mittal BR, Behera A, Gorla AKR, et al. Comparative effectiveness of ultrasonography, 99mTc-sestamibi, and 18F-fluorocholine PET\/CT in detecting parathyroid adenomas in patients with primary hyperparathyroidism. Clin Nucl Med 2017; 42: e491\u20137. doi: 10.1097\/RLU.0000000000001845","DOI":"10.1097\/RLU.0000000000001845"},{"key":"2026042912041408825_j_raon-2024-0058_ref_011","doi-asserted-by":"crossref","unstructured":"Beheshti M, Hehenwarter L, Paymani Z, Rendl G, Imamovic L, Rettenbacher R, et al. (18)F-Fluorocholine PET\/CT in the assessment of primary hyperparathyroidism compared with (99m)Tc-MIBI or (99m)Tc-tetrofosmin SPECT\/CT: a prospective dual-centre study in 100 patients. Eur J Nucl Med Mol Imaging 2018; 45: 1762\u201371. doi: 10.1007\/s00259-018-3980-9","DOI":"10.1007\/s00259-018-3980-9"},{"key":"2026042912041408825_j_raon-2024-0058_ref_012","doi-asserted-by":"crossref","unstructured":"Cuderman A, Senica K, Rep S, Hocevar M, Kocjan T, Sever MJ, et al. 18F-fluorocholine PET\/CT in primary hyperparathyroidism: superior diagnostic performance to conventional scintigraphic imaging for localization of hyperfunctioning parathyroid glands. J Nucl Med 2020; 61: 577\u201383. doi: 10.2967\/jnumed.119.229914","DOI":"10.2967\/jnumed.119.229914"},{"key":"2026042912041408825_j_raon-2024-0058_ref_013","doi-asserted-by":"crossref","unstructured":"Imperiale A, Bani J, Bottoni G, Latg\u00e9 A, Heimburger C, Catrambone U, et al. Does (18)F-Fluorocholine PET\/CT add value to positive parathyroid scintigraphy in the presurgical assessment of primary hyperparathyroidism? Front Med 2023; 10: 1148287. doi: 10.3389\/fmed.2023.1148287","DOI":"10.3389\/fmed.2023.1148287"},{"key":"2026042912041408825_j_raon-2024-0058_ref_014","doi-asserted-by":"crossref","unstructured":"Rep S, Hocevar M, Vaupotic J, Zdesar U, Zaletel K, Lezaic L. 18F-choline PET\/CT for parathyroid scintigraphy: significantly lower radiation exposure of patients in comparison to conventional nuclear medicine imaging approaches. J Radiol Prot 2018; 38: 343\u201356. doi: 10.1088\/1361-6498\/aaa86f","DOI":"10.1088\/1361-6498\/aaa86f"},{"key":"2026042912041408825_j_raon-2024-0058_ref_015","doi-asserted-by":"crossref","unstructured":"Ahuja AT, Wong KT, Ching AS, Fung MK, Lau JY, Yuen EH, et al. Imaging for primary hyperparathyroidism--what beginners should know. Clin Radiol 2004; 59: 967\u201376. doi: 10.1016\/j.crad.2004.04.005","DOI":"10.1016\/j.crad.2004.04.005"},{"key":"2026042912041408825_j_raon-2024-0058_ref_016","doi-asserted-by":"crossref","unstructured":"D\u00edaz-Aguirregoitia FJ, Emparan C, Gaztambide S, Aniel-Quiroga MA, Busturia MA, V\u00e1zquez JA, et al. Intraoperative monitoring of kinetic total serum calcium levels in primary hyperparathyroidism surgery. J Am Coll Surg 2004; 198: 519\u201324. doi: 10.1016\/j.jamcollsurg.2003.12.006","DOI":"10.1016\/j.jamcollsurg.2003.12.006"},{"key":"2026042912041408825_j_raon-2024-0058_ref_017","doi-asserted-by":"crossref","unstructured":"Bergenfelz A, Lindblom P, Tibblin S, Westerdahl J. Unilateral versus bilateral neck exploration for primary hyperparathyroidism: a prospective randomized controlled trial. Ann Surg 2002; 236: 543\u201351. doi: 10.1097\/00000658-200211000-00001","DOI":"10.1097\/00000658-200211000-00001"},{"key":"2026042912041408825_j_raon-2024-0058_ref_018","doi-asserted-by":"crossref","unstructured":"Inabnet WB 3rd, Dakin GF, Haber RS, Rubino F, Diamond EJ, Gagner M. Targeted parathyroidectomy in the era of intraoperative parathormone monitoring. World J Surg 2002; 26: 921\u20135. doi: 10.1007\/s00268-002-6619-7","DOI":"10.1007\/s00268-002-6619-7"},{"key":"2026042912041408825_j_raon-2024-0058_ref_019","doi-asserted-by":"crossref","unstructured":"Dillavou ED, Cohn HE. Minimally invasive parathyroidectomy: 101 consecutive cases from a single surgeon. J Am Coll Surg 2003; 197: 1\u20137. doi: 10.1016\/S1072-7515(03)00113-3","DOI":"10.1016\/S1072-7515(03)00113-3"},{"key":"2026042912041408825_j_raon-2024-0058_ref_020","doi-asserted-by":"crossref","unstructured":"Treglia G, Piccardo A, Imperiale A, Strobel K, Kaufmann PA, Prior JO, et al. Diagnostic performance of choline PET for detection of hyperfunctioning parathyroid glands in hyperparathyroidism: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging 2019; 46: 751\u201365. doi: 10.1007\/s00259-018-4123-z","DOI":"10.1007\/s00259-018-4123-z"},{"key":"2026042912041408825_j_raon-2024-0058_ref_021","doi-asserted-by":"crossref","unstructured":"Jansen FP, Vanderheyden JL. The future of SPECT in a time of PET. Nucl Med Biol 2007; 34: 733\u20135. doi: 10.1016\/j.nucmedbio.2007.06.013.","DOI":"10.1016\/j.nucmedbio.2007.06.013"},{"key":"2026042912041408825_j_raon-2024-0058_ref_022","doi-asserted-by":"crossref","unstructured":"Nichols KJ, Tomas MB, Tronco GG, Rini JN, Kunjummen BD, Heller KS, et al. Preoperative parathyroid scintigraphic lesion localization: accuracy of various types of readings. Radiology 2008; 248: 221\u201332. doi: 10.1148\/radiol.2481071066","DOI":"10.1148\/radiol.2481071066"},{"key":"2026042912041408825_j_raon-2024-0058_ref_023","doi-asserted-by":"crossref","unstructured":"Broos WAM, Wondergem M, Knol RJJ, van der Zant FM. Parathyroid imaging with 18F-fluorocholine PET\/CT as a first-line imaging modality in primary hyperparathyroidism: a retrospective cohort study. EJNMMI Res 2019; 9: 72. doi: 10.1186\/s13550-019-0544-3","DOI":"10.1186\/s13550-019-0544-3"},{"key":"2026042912041408825_j_raon-2024-0058_ref_024","doi-asserted-by":"crossref","unstructured":"Imperiale A, Ta\u00efeb D, Hindi\u00e9 E. 18F-fluorocholine PET\/CT as a second line nuclear imaging technique before surgery for primary hyperparathyroidism. Eur J Nucl Med Mol Imaging 2018; 45: 654\u20137. doi: 10.1007\/s00259-017-3920-0","DOI":"10.1007\/s00259-017-3920-0"},{"key":"2026042912041408825_j_raon-2024-0058_ref_025","doi-asserted-by":"crossref","unstructured":"Evangelista L, Ravelli I, Magnani F, Iacobone M, Giraudo C, Camozzi V, et al. 18F-choline PET\/CT and PET\/MRI in primary and recurrent hyperparathyroidism: a systematic review of the literature. Ann Nucl Med 2020; 34: 601\u201319. doi: 10.1007\/s12149-020-01507-1","DOI":"10.1007\/s12149-020-01507-1"},{"key":"2026042912041408825_j_raon-2024-0058_ref_026","doi-asserted-by":"crossref","unstructured":"Hindi\u00e9 E, Zanotti-Fregonara P, Tabarin A, Rubello D, Morelec I, Wagner T, et al. The role of radionuclide imaging in the surgical management of primary hyperparathyroidism. J Nucl Med 2015; 56: 737\u201344. doi: 10.2967\/jnumed.115.156018","DOI":"10.2967\/jnumed.115.156018"},{"key":"2026042912041408825_j_raon-2024-0058_ref_027","doi-asserted-by":"crossref","unstructured":"Quak E, Lasne-Cardon A, Cavarec M, Lireux B, Bastit V, Roudaut N, et al. F18-Choline PET\/CT or MIBI SPECT\/CT in the surgical management of primary hyperparathyroidism: a diagnostic randomized clinical trial. JAMA Otolaryngol Head Neck Surg 2024; 150: 658\u201365. doi: 10.1001\/jamaoto.2024.1421","DOI":"10.1001\/jamaoto.2024.1421"},{"key":"2026042912041408825_j_raon-2024-0058_ref_028","doi-asserted-by":"crossref","unstructured":"Quak E, Lasne Cardon A, Ciappuccini R, Lasnon C, Bastit V, Le Henaff V, et al. Upfront F18-choline PET\/CT versus Tc99m-sestaMIBI SPECT\/CT guided surgery in primary hyperparathyroidism: the randomized phase III diagnostic trial APACH2. BMC Endocr Disord 2021; 21: 3. doi: 10.1186\/s12902-020-00667-5","DOI":"10.1186\/s12902-020-00667-5"},{"key":"2026042912041408825_j_raon-2024-0058_ref_029","doi-asserted-by":"crossref","unstructured":"Yap A, Hope TA, Graves CE, Kluijfhout W, Shen WT, Gosnell JE, et al. A costutility analysis of 18F-fluorocholine-positron emission tomography imaging for localizing primary hyperparathyroidism in the United States. Surgery 2022; 171: 55\u201362. doi: 10.1016\/j.surg.2021.03.075","DOI":"10.1016\/j.surg.2021.03.075"},{"key":"2026042912041408825_j_raon-2024-0058_ref_030","doi-asserted-by":"crossref","unstructured":"van Mossel S, Saing S, Appelman-Dijkstra N, Quak E, Schepers A, Smit F, et al. Cost-effectiveness of one-stop-shop [(18)F]fluorocholine PET\/CT to localise parathyroid adenomas in patients suffering from primary hyperparathyroidism. Eur J Nucl Med Mol Imaging 2024. 51: 3585\u201395. doi: 10.1007\/s00259-024-06771-1.","DOI":"10.1007\/s00259-024-06771-1"}],"container-title":["Radiology and Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/reference-global.com\/pdf\/10.2478\/raon-2024-0058","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T17:10:46Z","timestamp":1777482646000},"score":1,"resource":{"primary":{"URL":"https:\/\/reference-global.com\/article\/10.2478\/raon-2024-0058"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,28]]},"references-count":30,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,11,28]]},"published-print":{"date-parts":[[2024,12,1]]}},"alternative-id":["10.2478\/raon-2024-0058"],"URL":"https:\/\/doi.org\/10.2478\/raon-2024-0058","relation":{},"ISSN":["1581-3207"],"issn-type":[{"value":"1581-3207","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,28]]}}}