Serena Grimaldi1, Jacques Young2, Peter Kamenicky2, Dana Hartl3, Marie Terroir4, Sophie Leboulleux4, Amandine Berdelou4, Julien Hadoux4, Segolene Hescot4, Hervé Remy4, Eric Baudin4, Martin Schlumberger4, Désirée Deandreis4,5. 1. Nuclear Medicine and Endocrine Tumors, Gustave Roussy, 94800, Villejuif, France. sere.grimaldi@gmail.com. 2. Department of Endocrinology, Université Paris Sud, Assistance Publique-Hôpitaux de Paris, Bicetre Hospital and INSERM U1185, 78 rue du Général Leclercq, 94275, Le Kremlin Bicêtre, France. 3. Division of Surgical Oncology, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France. 4. Nuclear Medicine and Endocrine Tumors, Gustave Roussy, 94800, Villejuif, France. 5. Nuclear Medicine Unit, Department of Medical Sciences, University of Turin, corso Bramante 88, 10126, Torino, Italy.
Abstract
PURPOSE: To evaluate the added value of 18F-Fluorocholine (18F-FCH) PET/CT in presurgical imaging of patients with primary hyperparathyroidism (HPT) and challenging localization of the hyper-functioning parathyroid glands. METHODS: We included 27 consecutive patients with primary HPT (19 F; median age: 58 years), with either (i) non-conclusive pre-surgical localization with 99mTc-sestaMIBI scintigraphy and neck ultrasonography (US), (ii) recurrence of previously operated HPT, or (iii) familiar HPT with a suspicion of multiple gland disease. Histological findings and resolution of HPT were considered as the gold standard. RESULTS: 18F-FCH PET/CT was positive in 24/27 patients. Twenty-one patients underwent surgery with 27 resected lesions (14 adenomas, 11 hyperplastic glands, two hyper-functioning histologically normal glands), with resolution of HPT in 19/21 patients (90%). 18F-FCH PET/CT localized 22 lesions in 17/21 patients (per patient: sensitivity 81%, positive predictive value (PPV) 94%; per gland: sensitivity 76%, PPV 85%, specificity 91%, negative predictive value (NPV) 86%). 18F-FCH PET/CT found eight lesions which were undetectable on both 99mTc-sestaMIBI scintigraphy and US. In patients with a familial HPT and/or a multiple gland disease, sensitivity was 100 and 79% on a per-patient and a per-gland analysis respectively, while NPV was 63%. In six patients with a persistence or recurrence of previously treated HPT, 18F-FCH PET/CT localized all lesions, both in sporadic and familiar disease. CONCLUSIONS: 18F-FCH PET/CT is a promising modality in challenging pre-surgical localization of hyper-functioning parathyroid glands, such as inconclusive standard imaging, recurrence after surgery, or suspected multiple gland disease.
PURPOSE: To evaluate the added value of 18F-Fluorocholine (18F-FCH) PET/CT in presurgical imaging of patients with primary hyperparathyroidism (HPT) and challenging localization of the hyper-functioning parathyroid glands. METHODS: We included 27 consecutive patients with primary HPT (19 F; median age: 58 years), with either (i) non-conclusive pre-surgical localization with 99mTc-sestaMIBI scintigraphy and neck ultrasonography (US), (ii) recurrence of previously operated HPT, or (iii) familiar HPT with a suspicion of multiple gland disease. Histological findings and resolution of HPT were considered as the gold standard. RESULTS:18F-FCH PET/CT was positive in 24/27 patients. Twenty-one patients underwent surgery with 27 resected lesions (14 adenomas, 11 hyperplastic glands, two hyper-functioning histologically normal glands), with resolution of HPT in 19/21 patients (90%). 18F-FCH PET/CT localized 22 lesions in 17/21 patients (per patient: sensitivity 81%, positive predictive value (PPV) 94%; per gland: sensitivity 76%, PPV 85%, specificity 91%, negative predictive value (NPV) 86%). 18F-FCH PET/CT found eight lesions which were undetectable on both 99mTc-sestaMIBI scintigraphy and US. In patients with a familial HPT and/or a multiple gland disease, sensitivity was 100 and 79% on a per-patient and a per-gland analysis respectively, while NPV was 63%. In six patients with a persistence or recurrence of previously treated HPT, 18F-FCH PET/CT localized all lesions, both in sporadic and familiar disease. CONCLUSIONS:18F-FCH PET/CT is a promising modality in challenging pre-surgical localization of hyper-functioning parathyroid glands, such as inconclusive standard imaging, recurrence after surgery, or suspected multiple gland disease.
Authors: Dina M Elaraj; Rebecca S Sippel; Sheila Lindsay; Ileana Sansano; Quan-Yang Duh; Orlo H Clark; Electron Kebebew Journal: Arch Surg Date: 2010-06
Authors: Arnoldo Piccardo; P Trimboli; M Rutigliani; M Puntoni; L Foppiani; L Bacigalupo; Anna Crescenzi; G Bottoni; G Treglia; F Paparo; P Del Monte; M Lanata; G Paone; G Ferrarazzo; U Catrambone; A Arlandini; L Ceriani; M Cabria; L Giovanella Journal: Eur J Nucl Med Mol Imaging Date: 2018-09-15 Impact factor: 9.236
Authors: Giorgio Treglia; Arnoldo Piccardo; Alessio Imperiale; Klaus Strobel; Philipp A Kaufmann; John O Prior; Luca Giovanella Journal: Eur J Nucl Med Mol Imaging Date: 2018-08-09 Impact factor: 9.236
Authors: Diego Alfonso López-Mora; Marina Sizova; Montserrat Estorch; Albert Flotats; Valle Camacho; Alejandro Fernández; Safae Abouzian; Francisco Fuentes-Ocampo; José Ignacio Pérez Garcia; Ana Isabel Chico Ballesteros; Joan Duch; Anna Domènech; Antonio Moral Duarte; Ignasi Carrió Journal: Eur J Nucl Med Mol Imaging Date: 2020-01-09 Impact factor: 9.236