PT  - JOURNAL ARTICLE
AU  - Thomas A. Hope
AU  - Claire E. Graves
AU  - Jeremie Calais
AU  - Eric C. Ehman
AU  - Geoffrey B. Johnson
AU  - Daniel Thompson
AU  - Maya Aslam
AU  - Quan-Yang Duh
AU  - Jessica E. Gosnell
AU  - Wen T. Shen
AU  - Sanziana A. Roman
AU  - Julie A. Sosa
AU  - Wouter P. Kluijfhout
AU  - Carolyn D. Seib
AU  - Javier E. Villaneuva-Meyer
AU  - Miguel H. Pampaloni
AU  - Insoo Suh
TI  - Accuracy of <sup>18</sup>F-Fluorocholine PET for the Detection of Parathyroid Adenomas: Prospective Single-Center Study
AID  - 10.2967/jnumed.120.256735
DP  - 2021 Nov 01
TA  - Journal of Nuclear Medicine
PG  - 1511--1516
VI  - 62
IP  - 11
4099  - http://jnm.snmjournals.org/content/62/11/1511.short
4100  - http://jnm.snmjournals.org/content/62/11/1511.full
SO  - J Nucl Med2021 Nov 01; 62
AB  - The purpose of this prospective study was to determine the correct localization rate (CLR) of 18F-fluorocholine PET for the detection of parathyroid adenomas in comparison to 99mTc-sestamibi imaging. Methods: This was a single-arm prospective trial. Ninety-eight patients with biochemical evidence of primary hyperparathyroidism were imaged before parathyroidectomy using 18F-fluorocholine PET/MRI. 99mTc-sestamibi imaging performed separately from the study was evaluated for comparison. The primary endpoint of the study was the CLR on a patient level. Each imaging study was interpreted by 3 masked readers on a per-region basis. Lesions were validated by histopathologic analysis of surgical specimens. Results: Of the 98 patients who underwent 18F-fluorocholine PET, 77 subsequently underwent parathyroidectomy and 60 of those had 99mTc-sestamibi imaging. For 18F-fluorocholine PET in patients who underwent parathyroidectomy, the CLR based on the masked reader consensus was 75% (95% CI, 0.63–0.82). In patients who underwent surgery and had an available 99mTc-sestamibi study, the CLR increased from 17% (95% CI, 0.10–0.27) for 99mTc-sestamibi imaging to 70% (95% CI, 0.59–0.79) for 18F-fluorocholine PET. Conclusion: In this prospective study using masked readers, the CLR for 18F-fluorocholine PET was 75%. In patients with a paired 99mTc-sestamibi study, the use of 18F-fluorocholine PET increased the CLR from 17% to 70%. 18F-fluorocholine PET is a superior imaging modality for the localization of parathyroid adenomas.