I Bossert1, S Chytiris2, M Hodolic3,4,5,6, L Croce2, L Mansi7, L Chiovato8, G Mariani9, G Trifirò1. 1. Unit of Nuclear Medicine, ICS Maugeri, 27100, Pavia, Italy. 2. Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, 27100, Pavia, Italy. 3. Nuclear Medicine Research Department, Iason, Graz, Austria. 4. Nuclear Medicine Department, Iason, Graz, Austria. 5. Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic. 6. Nuclear Medicine Department, Policlinico S. Orsola Malpighi, University of Bologna, Bologna, Italy. 7. Inter-Universitary Research Center for Sustainable Development (CIRPS), Naples, Italy. 8. Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S, University of Pavia, Via S. Maugeri 10, 27100, Pavia, Italy. luca.chiovato@icsmaugeri.it. 9. Regional Center of Nuclear Medicine, University of Pisa, Pisa, Italy.
Abstract
PURPOSE: Identification of pathologic parathyroid glands in primary hyperparathyroidism, traditionally based on neck ultrasound (US) and/or 99mTc-Sestamibi scintigraphy, can be challenging. PET/CT with 18F-Fluorocholine (18F-FCH) might improve the detection of pathologic parathyroid glands. We aimed at comparing the diagnostic performance of 18F-FCH-PET/CT with that of dual-phase dual-isotope parathyroid scintigraphy and neck US. METHODS: Thirty-four consecutive patients with primary hyperparathyroidism were prospectively enrolled, 7 had normocalcemic hyperparathyroidism, and 27 had classic hypercalcemic hyperparathyroidism. All patients underwent high-resolution neck US, dual-phase dual-isotope 99mTc-Pertechnetate/99mTc-Sestamibi scintigraphy, and 18F-FCH-PET/CT. RESULTS: In the whole patients' group, the detection rates of the abnormal parathyroid gland were 68% for neck US, 71% for 18F-FCH-PET/CT, and only 15% for 99mTc-Sestamibi scintigraphy. The corresponding figures in normocalcemic and hypercalcemic hyperparathyroidism were 57 and 70% for neck US, 70 and 71% for 18F-FCH-PET/CT, and 0 and 18% for 99mTc-Sestamibi scintigraphy, respectively. In the 17 patients in whom the abnormal parathyroid gland was identified, either at surgery or at fine needle aspiration cytology/biochemistry, the correct detection rate was 82% for neck US, 89% for 18F-FCH-PET/CT, and only 17% for 99mTc-Sestamibi scintigraphy. CONCLUSIONS: 18F-FCH-PET/CT can be considered a first-line imaging technique for the identification of pathologic parathyroid glands in patients with normocalcemic and hypercalcemic hyperparathyroidism, even when the parathyroid volume is small.
PURPOSE: Identification of pathologic parathyroid glands in primary hyperparathyroidism, traditionally based on neck ultrasound (US) and/or 99mTc-Sestamibi scintigraphy, can be challenging. PET/CT with 18F-Fluorocholine (18F-FCH) might improve the detection of pathologic parathyroid glands. We aimed at comparing the diagnostic performance of 18F-FCH-PET/CT with that of dual-phase dual-isotope parathyroid scintigraphy and neck US. METHODS: Thirty-four consecutive patients with primary hyperparathyroidism were prospectively enrolled, 7 had normocalcemic hyperparathyroidism, and 27 had classic hypercalcemic hyperparathyroidism. All patients underwent high-resolution neck US, dual-phase dual-isotope 99mTc-Pertechnetate/99mTc-Sestamibi scintigraphy, and 18F-FCH-PET/CT. RESULTS: In the whole patients' group, the detection rates of the abnormal parathyroid gland were 68% for neck US, 71% for 18F-FCH-PET/CT, and only 15% for 99mTc-Sestamibi scintigraphy. The corresponding figures in normocalcemic and hypercalcemic hyperparathyroidism were 57 and 70% for neck US, 70 and 71% for 18F-FCH-PET/CT, and 0 and 18% for 99mTc-Sestamibi scintigraphy, respectively. In the 17 patients in whom the abnormal parathyroid gland was identified, either at surgery or at fine needle aspiration cytology/biochemistry, the correct detection rate was 82% for neck US, 89% for 18F-FCH-PET/CT, and only 17% for 99mTc-Sestamibi scintigraphy. CONCLUSIONS: 18F-FCH-PET/CT can be considered a first-line imaging technique for the identification of pathologic parathyroid glands in patients with normocalcemic and hypercalcemic hyperparathyroidism, even when the parathyroid volume is small.
Entities:
Keywords:
Normocalcemic hyperparathyroidism; PETC/CT with 18F-Choline; Primary hyperparathyroidism
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
Authors: M E Noltes; S Kruijff; L Jansen; H E Westerlaan; W T Zandee; R A J O Dierckx; A H Brouwers Journal: EJNMMI Res Date: 2021-03-26 Impact factor: 3.138