open access

Vol 73, No 1 (2022)
Original paper
Submitted: 2021-09-17
Accepted: 2021-10-29
Published online: 2022-01-31
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The utility of 18F-fluorocholine PET/CT in the imaging of parathyroid adenomas

Andrzej Mazurek12, Mirosław Dziuk12, Ewa Witkowska-Patena12, Witold Chudzinski3, Stanisław Piszczek12, Agnieszka Gizewska12, Marek Saracyn4
·
Pubmed: 35119087
·
Endokrynol Pol 2022;73(1):43-48.
Affiliations
  1. Department of Nuclear Medicine, Military Institute of Medicine, Warsaw, Poland
  2. Affidea Mazovian PET-CT Medical Centre, Warsaw, Poland
  3. Department of General, Endocrine, and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland
  4. Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine, Warsaw, Poland

open access

Vol 73, No 1 (2022)
Original Paper
Submitted: 2021-09-17
Accepted: 2021-10-29
Published online: 2022-01-31

Abstract

Introduction: The aim of the study was to estimate the sensitivity of 18F-FCH PET/CT in preoperative localisation of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism (PHPT).

Material and methods: Sixty-five consecutive patients with PHPT, who underwent neck ultrasound (US) and  99mTc/99mTc-MIBI dual-phase parathyroid scintigraphy, were prospectively enrolled. Twenty-two patients had unsuccessful parathyroid surgery prior to the study. PET/CT scans were performed 65.0 ± 13.3 min after injection of 218.5 ± 31.9 MBq of 18F-fluorocholine (FCH). Three experienced nuclear medicine physicians assessed the detection rate of hyperfunctioning parathyroid tissue. Response to parathyroidectomy and clinical follow-up served as a reference test. Per-patient sensitivity and positive predictive value (PPV) were calculated for patients who underwent surgery.

Results: 18F-FCH PET/CT was positive in 61 patients, and negative in 4. US and parathyroid scintigraphy showed positive and negative results in 20, 45 and 17, 48, respectively. US showed nodular goitre in 31 patients and chronic thyroiditis in 9 patients. Parathyroid surgery was performed in 43 (66%) patients. 18F-FCH PET/CT yielded a sensitivity of 100% (95% CI: 87.99–100) and PPV of 85.7% (95% CI: 70.77–94.06). Similar values were observed in patients with chronic thyroiditis, nodular goitre, and patients after an unsuccessful parathyroid surgery. PET/CT identified hyperparathyroidism complications (kidney stones, osteoporotic bone fractures, and brown tumours) in 11 patients.

Conclusions: 18F-FCH PET/CT effectively detected hyperfunctioning parathyroid tissue and its complications. The method showed excellent sensitivity and positive predictive value, including patients with nodular goitre, chronic thyroiditis, and prior unsuccessful parathyroidectomy. PET/CT performance was superior to neck ultrasound and parathyroid scintigraphy.

Abstract

Introduction: The aim of the study was to estimate the sensitivity of 18F-FCH PET/CT in preoperative localisation of hyperfunctioning parathyroid glands in patients with primary hyperparathyroidism (PHPT).

Material and methods: Sixty-five consecutive patients with PHPT, who underwent neck ultrasound (US) and  99mTc/99mTc-MIBI dual-phase parathyroid scintigraphy, were prospectively enrolled. Twenty-two patients had unsuccessful parathyroid surgery prior to the study. PET/CT scans were performed 65.0 ± 13.3 min after injection of 218.5 ± 31.9 MBq of 18F-fluorocholine (FCH). Three experienced nuclear medicine physicians assessed the detection rate of hyperfunctioning parathyroid tissue. Response to parathyroidectomy and clinical follow-up served as a reference test. Per-patient sensitivity and positive predictive value (PPV) were calculated for patients who underwent surgery.

Results: 18F-FCH PET/CT was positive in 61 patients, and negative in 4. US and parathyroid scintigraphy showed positive and negative results in 20, 45 and 17, 48, respectively. US showed nodular goitre in 31 patients and chronic thyroiditis in 9 patients. Parathyroid surgery was performed in 43 (66%) patients. 18F-FCH PET/CT yielded a sensitivity of 100% (95% CI: 87.99–100) and PPV of 85.7% (95% CI: 70.77–94.06). Similar values were observed in patients with chronic thyroiditis, nodular goitre, and patients after an unsuccessful parathyroid surgery. PET/CT identified hyperparathyroidism complications (kidney stones, osteoporotic bone fractures, and brown tumours) in 11 patients.

Conclusions: 18F-FCH PET/CT effectively detected hyperfunctioning parathyroid tissue and its complications. The method showed excellent sensitivity and positive predictive value, including patients with nodular goitre, chronic thyroiditis, and prior unsuccessful parathyroidectomy. PET/CT performance was superior to neck ultrasound and parathyroid scintigraphy.

Get Citation

Keywords

18F-FCH PET/CT; fluorocholine; hyperparathyroidism; parathyroid imaging

About this article
Title

The utility of 18F-fluorocholine PET/CT in the imaging of parathyroid adenomas

Journal

Endokrynologia Polska

Issue

Vol 73, No 1 (2022)

Article type

Original paper

Pages

43-48

Published online

2022-01-31

Page views

5945

Article views/downloads

687

DOI

10.5603/EP.a2021.0107

Pubmed

35119087

Bibliographic record

Endokrynol Pol 2022;73(1):43-48.

Keywords

18F-FCH PET/CT
fluorocholine
hyperparathyroidism
parathyroid imaging

Authors

Andrzej Mazurek
Mirosław Dziuk
Ewa Witkowska-Patena
Witold Chudzinski
Stanisław Piszczek
Agnieszka Gizewska
Marek Saracyn

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