Luca Giovanella1,2, Lorenzo Bacigalupo3, Giorgio Treglia4,5,6, Arnoldo Piccardo3. 1. Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland. luca.giovanella@eoc.ch. 2. Clinic for Nuclear Medicine, University Hospital and University of Zurich, Zurich, Switzerland. luca.giovanella@eoc.ch. 3. Department of Diagnostic Imaging, Radiology and Nuclear Medicine, Ente Ospedaliero Galliera, Genova, Italy. 4. Clinic for Nuclear Medicine and Molecular Imaging, Imaging Institute of Southern Switzerland, Bellinzona, Switzerland. 5. Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland. 6. Research and Innovation Service, Academic Education, Research and Innovation Area, General Directorate, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Abstract
INTRODUCTION: Primary hyperparathyroidism (PHPT) is a common endocrine disorder usually due to hyperfunctioning parathyroid glands (HPs). Surgical removal of the HPs is the main treatment for PHPT, making the correct detection and localization of HPs crucial to guiding targeted and minimally invasive surgical treatment in patients with PHPT. To date, different imaging methods have been used to detect and localize HPs, including radiology, nuclear medicine, and hybrid techniques. METHODS: The present work discusses the role and value of different imaging methods in PHPT and, particularly, evaluates the potential role of 18F-fluorcholine PET/CT as a "one-stop-shop" method for preoperative parathyroid localization in patients with PHPT. DISCUSSION: Cervical ultrasound (US) and parathyroid scintigraphy using 99mTc-MIBI are the most commonly employed methods in clinical practice. More recently, four-dimensional computed tomography (4D CT) and positron emission tomography (PET) with radiolabeled choline have emerged as useful alternatives in cases of negative or discordant findings from first-line imaging methods. CONCLUSIONS: Due to the excellent diagnostic performance of radiolabeled choline PET/CT and the low radiation burden, this technique seems to be an ideal candidate to substitute current imaging procedures including US, MIBI scintigraphy, 4D CT and MRI and perform a fast and reliable "one-stop-shop" preoperative localization of HP in patients with PHPT, including challenging cases of postoperative persistent/recurrent disease.
INTRODUCTION:Primary hyperparathyroidism (PHPT) is a common endocrine disorder usually due to hyperfunctioning parathyroid glands (HPs). Surgical removal of the HPs is the main treatment for PHPT, making the correct detection and localization of HPs crucial to guiding targeted and minimally invasive surgical treatment in patients with PHPT. To date, different imaging methods have been used to detect and localize HPs, including radiology, nuclear medicine, and hybrid techniques. METHODS: The present work discusses the role and value of different imaging methods in PHPT and, particularly, evaluates the potential role of 18F-fluorcholine PET/CT as a "one-stop-shop" method for preoperative parathyroid localization in patients with PHPT. DISCUSSION: Cervical ultrasound (US) and parathyroid scintigraphy using 99mTc-MIBI are the most commonly employed methods in clinical practice. More recently, four-dimensional computed tomography (4D CT) and positron emission tomography (PET) with radiolabeled choline have emerged as useful alternatives in cases of negative or discordant findings from first-line imaging methods. CONCLUSIONS: Due to the excellent diagnostic performance of radiolabeled choline PET/CT and the low radiation burden, this technique seems to be an ideal candidate to substitute current imaging procedures including US, MIBI scintigraphy, 4D CT and MRI and perform a fast and reliable "one-stop-shop" preoperative localization of HP in patients with PHPT, including challenging cases of postoperative persistent/recurrent disease.
Authors: Scott M Wilhelm; Tracy S Wang; Daniel T Ruan; James A Lee; Sylvia L Asa; Quan-Yang Duh; Gerard M Doherty; Miguel F Herrera; Janice L Pasieka; Nancy D Perrier; Shonni J Silverberg; Carmen C Solórzano; Cord Sturgeon; Mitchell E Tublin; Robert Udelsman; Sally E Carty Journal: JAMA Surg Date: 2016-10-01 Impact factor: 14.766
Authors: Wouter P Kluijfhout; Wessel M C M Vorselaars; Sandra A M van den Berk; Menno R Vriens; Inne H M Borel Rinkes; Gerlof D Valk; Thijs van Dalen; John M H de Klerk; Bart de Keizer Journal: Nucl Med Commun Date: 2016-12 Impact factor: 1.690
Authors: Jacqueline Bijnens; Annick Van den Bruel; Vincent Vander Poorten; Ingeborg Goethals; Steven Van Schandevyl; Catherine Dick; Frank De Geeter Journal: Sci Rep Date: 2022-10-19 Impact factor: 4.996
Authors: Julie W Christensen; Afefah Ismail; Susanne B Søndergaard; Finn N Bennedbaek; Birte Nygaard; Lars T Jensen; Waldemar Trolle; Christoffer Holst-Hahn; Bo Zerahn; Bent Kristensen; Martin Krakauer Journal: Clin Endocrinol (Oxf) Date: 2022-02-21 Impact factor: 3.523
Authors: Adrien Latge; Sophie Riehm; Michel Vix; Jacob Bani; Mihaela Ignat; Valentin Pretet; Mehdi Helali; Giorgio Treglia; Alessio Imperiale Journal: Diagnostics (Basel) Date: 2021-12-17