18F-Fluorocholine PET/CT Is More Sensitive Than 11C-Methionine PET/CT for the Localization of Hyperfunctioning Parathyroid Tissue in Primary Hyperparathyroidism

Article Figures & Data

Download figure
Open in new tab
Download powerpoint
Download figure
Open in new tab
Download powerpoint
FIGURE 1.
Flowchart. PCa = parathyroid carcinoma; PH = parathyroid hyperplasia.
Download figure
Open in new tab
Download powerpoint
FIGURE 2.
Correlation between ¹⁸F-FCH (early [A] and late [B]) and ¹¹C-MET uptake. ****P < 0.0001.
Download figure
Open in new tab
Download powerpoint
FIGURE 3.
Patient 3. Coronal PET/CT images of 67-y-old woman with pHPT and inconclusive ^99mTc-MIBI SPECT/CT (doubtful right inferior focus). (A) ¹¹C-MET images show asymmetric thyroid lobes with lower extension on left (arrow). (B) ¹⁸F-FCH_L images shows nodular uptake under base of left thyroid lobe (arrow). (C) PET/CT images detail nodular aspect of ¹⁸F-FCH uptake (arrow) in PA confirmed at histopathologic analysis.

TABLE 1.

Patient Characteristics (n = 53)

Characteristic	Value	Normal value
Sex (M/F)	16/37
Age (y)	58 ± 16
Body mass index (kg/m²)	28.2 ± 5.5
Prior parathyroidectomy	7 (13)
Prior
^99mTc-MIBI SPECT/CT
Negative	38 (72)
Inconclusive	15 (28)
Ultrasonography	35 (66)
Other	9 (17)
Baseline laboratory values
PTH (ng/L)	72.0 (54–101)	4–49
Calcium (mmol/L)	2.67 (2.62–2.69)	2.12–2.62
Phosphorus (mmol/L)	0.75 ± 0.17	0.81–1.45
25-hydroxycholecalciferol (ng/mL)	24.74 ± 8.97	30–80
¹¹C-MET results
Positive	25 (47)
Negative*	28 (53)
¹⁸F-FCH results
Positive	39 (74)
Negative^*	14 (26)
Surgical results (n = 26)
Pathologic parathyroid tissue found	24 (92)
Biologic normalization during follow-up	21 (81)^†

* Negative imaging includes negative or inconclusive results.
↵^†2 patients were lost to follow-up.
Qualitative data are number and percentage; continuous data are mean ± SD; nonnormal continuous data are median and 25th–75th percentiles (D’Agostino–Pearson omnibus test).