PETC/CT with 18F-Choline Localizes Hyperfunctioning Parathyroid Adenomas Equally well in Normocalcemic Hyperparathyroidism as in overt Hyperparathyroidism.

 PET

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
  • The aim of this study was to compare 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, seven 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
    • 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
    • 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
    • 0% and 18% for 99mTc-Sestamibi scintigraphy
  • 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
      • 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
SUMMARY:

👉The diagnostic performance of 18F-FCH-PET / CT may be better than that of dual-phase dual-isotope parathyroid scintigraphy or neck US in normocalcemic or hypercalcemic primary hyperparathyroidism.

👉https://www.ncbi.nlm.nih.gov/pubmed/30094743/

#Arrangoiz #ParathyroidSurgeon #ParathyroidExpert #Hyperparathyroidism #PrimaryHyperparathyroidism #CancerSurgeon #EndocrineSurgery #Teacher #Surgeon #HeadandNeckSurgeon #SurgicalOncologist #ParathyroidAdenoma #Hypercalcemia #ElevatedCalciumLevels #Miami #MountSinaiMedicalCenter #MSMC #Mexico #Hialeah

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