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The utility of 18F-fluorocholine PET/CT in the imaging of parathyroid adenomas
, 12, 12, 3, 12, 12, 4
Affiliations- Department of Nuclear Medicine, Military Institute of Medicine, Warsaw, Poland
- Affidea Mazovian PET-CT Medical Centre, Warsaw, Poland
- Department of General, Endocrine, and Vascular Surgery, Medical University of Warsaw, Warsaw, Poland
- Department of Endocrinology and Radioisotope Therapy, Military Institute of Medicine, Warsaw, Poland
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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.
Keywords
18F-FCH PET/CT; fluorocholine; hyperparathyroidism; parathyroid imaging
About this articleTitle
The utility of 18F-fluorocholine PET/CT in the imaging of parathyroid adenomas
Journal
Issue
Article type
Original paper
Pages
43-48
Published online
2022-01-31
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5897
Article views/downloads
668
DOI
Pubmed
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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