DOI: 10.1007/s00259-014-2837-0Pages: 2083-2089

18F-Fluorocholine PET/CT for localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism: a pilot study

1. University Medical Centre Ljubljana, Department for Nuclear Medicine

2. University Medical Centre Ljubljana, Department of Endocrinology, Diabetes and Metabolic Diseases

3. Institute of Oncology, Department of Surgical Oncology

Correspondence to:
Luka Lezaic
Tel: +386 1 522 84 50
Email: luka.lezaic@kclj.si

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Abstract

Purpose

Primary hyperparathyroidism is a common endocrine disorder which is diagnosed biochemically and for which therapy is surgical. A prerequisite for minimally invasive surgery, which minimizes morbidity and cost, is accurate localization of the involved gland(s). The aim of this study was to evaluate the usefulness of 18F-fluorocholine PET/CT for preoperative localization of hyperfunctioning parathyroid tissue.

Methods

18F-Fluorocholine PET/CT and conventional parathyroid scintigraphic imaging consisting of 99mTc-sestaMIBI SPECT/CT, 99mTc-sestaMIBI dual-phase imaging and 99mTc-sestaMIBI/pertechnetate subtraction imaging were performed in 24 patients. The diagnostic performance of the imaging methods was compared against histology as the gold standard and postoperative serum Ca2+ and iPTH values.

Results

The sensitivity and specificity of 18F-fluorocholine PET/CT were 92 % and 100 %, respectively, in contrast to 49 % and 100 %, 46 % and 100 %, and 44 % and 100 % for 99mTc-sestaMIBI SPECT/CT, 99mTc-sestaMIBI/pertechnetate subtraction imaging and 99mTc-sestaMIBI dual-phase imaging, respectively. Combined conventional scintigraphic imaging had a sensitivity and specificity of 64 % and 100 %, respectively. The performance of 18F-fluorocholine PET/CT was superior particularly in patients with multiple lesions or hyperplasia.

Conclusion

18F-Fluorocholine PET/CT appears to be a promising, effective imaging method for localization of hyperfunctioning parathyroid tissue.

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  • Accepted: Jun 5, 2014
  • Online: Jul 26, 2014

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