ACCURACY OF CHOLINE PET/CT VS TC 99M SESTAMIBI SPECT/CT PARATHYROID IMAGING IN COMPARISON TO HISTOPATHOLOGY IN THE DIAGNOSIS OF PARATHYROID ADENOMA: A META-ANALYSIS

1095 Background: In the advent of the recently accepted use of Choline in Parathyroid PET/CT, we aimed to assess its accuracy in diagnosing parathyroid adenoma in comparison to the Tc 99m Sestamibi SPECT/CT parathyroid imaging, with histopathology as the reference standard. Methods: Cross-sectional studies from 2014 to 2019 were identified through MEDLINE, Pubmed, clinicaltrials.gov, and Google scholar. Our literature search yielded 13 articles in which only 5 met the set inclusion and exclusion criteria. Objectives: To determine the diagnostic accuracy of Choline PET/CT in comparison to Tc 99m Sestamibi parathyroid imaging in detecting parathyroid adenomas, with histopathology as the reference standard. RESULTS: Three published cross-sectional studies were included with a total of population of 157 patients. Choline PET/CT was found to have a pooled sensitivity of 0.99 (0.96-1.00), pooled specificity of 0.45 (0.17-0.77), positive likelihood ratio of 1.79 (1.1-2.9), negative likelihood ratio of 0.03 (0.0-0.1), positive predictive value of 96.0% (93.4-97.7%) and negative predictive value of 83.3% (39.0-97.6%), estimated with 95% CI. Tc 99m Sestamibi SPECT/CT parathyroid imaging had a pooled sensitivity of 0.77 (0.70-0.84), pooled specificity of 0.45 (0.17-0.44), positive likelihood ratio of 1.43 (0.8-2.4), negative likelihood ratio of 0.49 (0.2-1.4), positive predictive value of 96.0% (93.4-97.7%) and negative predictive value of 83.3% (39.0-97.6%), estimated with 95% CI. CONCLUSION: Choline PET/CT showed superior sensitivity, negative predictive value and negative likelihood ratio over Tc 99m Sestamibi SPECT/CT parathyroid imaging. The measured specificities, positive predictive values and positive likelihood ratios of both modalities were found to be similar.