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18F-Fluorocholine PET/CT for localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism: a pilot study

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Abstract

Purpose

Primary hyperparathyroidism is a common endocrine disorder which is diagnosed biochemically and for which therapy is surgical. A prerequisite for minimally invasive surgery, which minimizes morbidity and cost, is accurate localization of the involved gland(s). The aim of this study was to evaluate the usefulness of 18F-fluorocholine PET/CT for preoperative localization of hyperfunctioning parathyroid tissue.

Methods

18F-Fluorocholine PET/CT and conventional parathyroid scintigraphic imaging consisting of 99mTc-sestaMIBI SPECT/CT, 99mTc-sestaMIBI dual-phase imaging and 99mTc-sestaMIBI/pertechnetate subtraction imaging were performed in 24 patients. The diagnostic performance of the imaging methods was compared against histology as the gold standard and postoperative serum Ca2+ and iPTH values.

Results

The sensitivity and specificity of 18F-fluorocholine PET/CT were 92 % and 100 %, respectively, in contrast to 49 % and 100 %, 46 % and 100 %, and 44 % and 100 % for 99mTc-sestaMIBI SPECT/CT, 99mTc-sestaMIBI/pertechnetate subtraction imaging and 99mTc-sestaMIBI dual-phase imaging, respectively. Combined conventional scintigraphic imaging had a sensitivity and specificity of 64 % and 100 %, respectively. The performance of 18F-fluorocholine PET/CT was superior particularly in patients with multiple lesions or hyperplasia.

Conclusion

18F-Fluorocholine PET/CT appears to be a promising, effective imaging method for localization of hyperfunctioning parathyroid tissue.

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Authors and Affiliations

  1. Department for Nuclear Medicine, University Medical Centre Ljubljana, Zaloska 7, 1525, Ljubljana, Slovenia

    Luka Lezaic, Sebastijan Rep & Jure Fettich

  2. Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia

    Mojca Jensterle Sever & Tomaz Kocjan

  3. Department of Surgical Oncology, Institute of Oncology, Ljubljana, Slovenia

    Marko Hocevar

Authors
  1. Luka Lezaic
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  2. Sebastijan Rep
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  3. Mojca Jensterle Sever
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  4. Tomaz Kocjan
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  5. Marko Hocevar
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  6. Jure Fettich
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Correspondence to Luka Lezaic.

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Lezaic, L., Rep, S., Sever, M.J. et al. 18F-Fluorocholine PET/CT for localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism: a pilot study. Eur J Nucl Med Mol Imaging 41, 2083–2089 (2014). https://doi.org/10.1007/s00259-014-2837-0

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  • DOI: https://doi.org/10.1007/s00259-014-2837-0

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