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Journal of Endocrinological Investigation

Erschienen in:

01.04.2019 | Original Article

PETC/CT with ¹⁸F-Choline localizes hyperfunctioning parathyroid adenomas equally well in normocalcemic hyperparathyroidism as in overt hyperparathyroidism

verfasst von: I. Bossert, S. Chytiris, M. Hodolic, L. Croce, L. Mansi, L. Chiovato, G. Mariani, G. Trifirò

Erschienen in: Journal of Endocrinological Investigation | Ausgabe 4/2019

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Abstract

Purpose

Identification of pathologic parathyroid glands in primary hyperparathyroidism, traditionally based on neck ultrasound (US) and/or ^99mTc-Sestamibi scintigraphy, can be challenging. PET/CT with ¹⁸F-Fluorocholine (¹⁸F-FCH) might improve the detection of pathologic parathyroid glands. We aimed at comparing the diagnostic performance of ¹⁸F-FCH-PET/CT with that of dual-phase dual-isotope parathyroid scintigraphy and neck US.

Methods

Thirty-four consecutive patients with primary hyperparathyroidism were prospectively enrolled, 7 had normocalcemic hyperparathyroidism, and 27 had classic hypercalcemic hyperparathyroidism. All patients underwent high-resolution neck US, dual-phase dual-isotope ^99mTc-Pertechnetate/^99mTc-Sestamibi scintigraphy, and ¹⁸F-FCH-PET/CT.

Results

In the whole patients’ group, the detection rates of the abnormal parathyroid gland were 68% for neck US, 71% for ¹⁸F-FCH-PET/CT, and only 15% for ^99mTc-Sestamibi scintigraphy. The corresponding figures in normocalcemic and hypercalcemic hyperparathyroidism were 57 and 70% for neck US, 70 and 71% for ¹⁸F-FCH-PET/CT, and 0 and 18% for ^99mTc-Sestamibi scintigraphy, respectively. In the 17 patients in whom the abnormal parathyroid gland was identified, either at surgery or at fine needle aspiration cytology/biochemistry, the correct detection rate was 82% for neck US, 89% for ¹⁸F-FCH-PET/CT, and only 17% for ^99mTc-Sestamibi scintigraphy.

Conclusions

¹⁸F-FCH-PET/CT can be considered a first-line imaging technique for the identification of pathologic parathyroid glands in patients with normocalcemic and hypercalcemic hyperparathyroidism, even when the parathyroid volume is small.

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Titel: PETC/CT with 18F-Choline localizes hyperfunctioning parathyroid adenomas equally well in normocalcemic hyperparathyroidism as in overt hyperparathyroidism
verfasst von: I. Bossert
S. Chytiris
M. Hodolic
L. Croce
L. Mansi
L. Chiovato
G. Mariani
G. Trifirò
Publikationsdatum: 01.04.2019
Verlag: Springer International Publishing
Erschienen in: Journal of Endocrinological Investigation / Ausgabe 4/2019
Elektronische ISSN: 1720-8386
DOI: https://doi.org/10.1007/s40618-018-0931-z

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PETC/CT with ¹⁸F-Choline localizes hyperfunctioning parathyroid adenomas equally well in normocalcemic hyperparathyroidism as in overt hyperparathyroidism

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Purpose

Methods

Results

Conclusions

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