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

Ležaič, Luka; Rep, Sebastijan; Sever, Mojca Jensterle; Kocjan, Tomaž; Hočevar, Marko; Fettich, Jure

doi:10.1007/s00259-014-2837-0

Cited by 145 publications

(133 citation statements)

References 15 publications

Supporting

Mentioning

116

Contrasting

Unclassified

Order By: Relevance

“…Our data are in agreement with early series that have found high sensitivity of dualisotope scintigraphy with pinhole imaging in detection of MGD defined on the basis of parathyroid four-gland identification (18,24). Head-to-head comparison between 123 I/ 99m Tc-sestamibi PS and the recently introduced 18 F-fluorocholine PET/CT in a large series of pHPT, including medico-economic aspects, will be of particular interest (25,26).…”

Section: European Journal Of Endocrinologysupporting

confidence: 91%

Preoperative imaging for focused parathyroidectomy: making a good strategy even better

Guérin

Lowery

Gabriel

et al. 2015

European Journal of Endocrinology

View full text Add to dashboard Cite

Objective: Surgical treatment for primary hyperparathyroidism (pHPT) has undergone a major paradigm shift during the last decades from bilateral cervicotomy with four-gland neck exploration to image-guided focused approaches. The primary objective of the present study was to compare the performances of parathyroid scintigraphy (PS), parathyroid ultrasonography (US), and the combination of both procedures for guiding a focused approach on the basis of modified interpretation criteria. Methods: Data from 199 patients operated for apparent sporadic pHPT and evaluated with US and PS using dual-isotope 123 I/ 99m Tc-sestamibi planar pinhole and single-photon emission computed tomography (SPECT) acqusitions were evaluated. Results: A total of 127 patients underwent a focused approach and the remainder had bilateral cervicotomy. In 42 cases, a focused approach was not performed due to the absence of concordant results between US and PS for a single-gland abnormality. Four patients had persistent disease and three had recurrent disease. A localizing preoperative PS had a sensitivity of 93.3%, positive predictive value of 85.8%, negative predictive value of 73.0%, and accuracy of 83.4% for predicting uniglandular disease. Additional SPECT images accurately localize posterior adenomas that are often missed by US. Compared with PS, US had a lower sensitivity (P!0.01). Our imaging protocol also enabled diagnosis of multiglandular disease in 60.6%. Conclusions: PS using a highly sensitive dual-tracer subtraction method is the most accurate technique for directing a focused approach. PS could be sufficient for directing a focused approach in the presence of a negative US in two major circumstances: posterior locations due to acquired ectopia that could be missed by US, and previous history of thyroidectomy due to interpretation difficulties.

show abstract

Section: European Journal Of Endocrinologysupporting

confidence: 91%

Preoperative imaging for focused parathyroidectomy: making a good strategy even better

Guérin

Lowery

Gabriel

et al. 2015

European Journal of Endocrinology

View full text Add to dashboard Cite

show abstract

“…The authors of the present study have observed that the medians of pre-operative PTH concentrations in patients with PHPT range from 83 to 434 pg/mL [11][12][13][14][15]. Cheon et al observed that there is a statistically significant difference between PTH concentrations in blood serum of patients with parathyroid adenoma and with parathyroid cancer.…”

Section: Discussionmentioning

confidence: 68%

Semi-quantitative method for the assessment of focal lesions in parathyroid scintigraphy with relation to histopathology: a prospective study

et al. 2017

View full text Add to dashboard Cite

BBACKGROUND:The aim of this paper was to analyse our own semi-quantitative method of assessing focal lesions localised in pre-operative diagnostic scintigraphy of primary hyperparathyroidism (PHPT) using 99m Tc-MIBI with washout and comparing these data with the result of the histopathological examination (HP). MATERIAL AND METHODS:A total of 40 (37 female, 3 male, average age 58.7 years) patients with a suspicion of PHPT were enrolled for prospective analysis. Dual phase planar and SPECT/CT examination with 99m Tc-MIBI were performed. The tumour to background ratios in the 10 th and 120 th minute were calculated (TBR10 and TBR120) on the basis of the planar acquisition.PTH, ionised calcium and phosphate levels were measured.Parathyroid surgery alone or combined with subtotal/total thyreoidectomy was conducted in 23 (57.5%) and 17 (42.5%) patients, respectively. A HP was performed in all patients. RESULTS:Average concentration of PTH in the whole group was 243.95 pg/ml. There was a statistically significant correlation between medians of PTH concentration and parathyroid histopathological results (p = 0.01). A total of 45 lesions of increased uptake were found in 32 (80.0%) and 34 (85%) patients in the early phase and the delayed phase, respectively.The post-operative material contained 20 (44.5%) parathyroid adenomas, 11 (24.5%) cases of hyperplasia, 2 (4.4%) cancers, 4 (8.9%) cases of normal parathyroid tissue, 2 (4.4%) lymph nodes and 6 (13.3%) cases of thyroid gland tissue.The medians of TBR10 and TBR120 for lesions examined in the HP were respectively: 3.64 and 2.59 for adenoma; 3.08 and 2.18 for hyperplasia; 7.7 and 5.5 for parathyroid cancer, 4.89 and 3.16 for normal tissue and 5.26 and 2.95 for lymph nodes or thyroid gland tissue.A high correlation coefficient of TBR10 to TBR120 in the parathyroid adenoma and parathyroid hyperplasia groups was observed with r = 0.867 and r = 0.964, respectively. The ρr correlation coefficient of TBR10 to TBR120 for normal parathyroid was 0.4.There was a statistically significant association between the HP and TBR10 medians (p = 0.047), but not between histopathology and TBR120 medians (p = 0.840

show abstract

“…7 Recently, dynamic contrast-enhanced CT imaging and choline PET/CT imaging have been advocated to identify parathyroid adenomas if conventional imaging was negative. [8][9][10][11][12][13] Normally functioning parathyroid glands are not seen on choline PET images, but occasionally incidental parathyroid adenomas are found in patients undergoing prostate cancer staging with choline PET, and hitherto unnoticed primary hyperparathyroidism is revealed. 11,14,15 Secondary hyperparathyroidism and tertiary hyperparathyroidism most often result in asymmetrical parathyroid gland hyperplasia and only subtle glandular enlargement, as seen in our case.…”

Section: Figurementioning

confidence: 99%

Visualization of Parathyroid Hyperplasia Using 18F-Fluorocholine PET/MR in a Patient With Secondary Hyperparathyroidism

Huellner

Aberle

Sah

et al. 2016

Clinical Nuclear Medicine

View full text Add to dashboard Cite

Several imaging modalities exist for the detection of parathyroid adenomas in patients with primary hyperparathyroidism. Unlike solitary parathyroid adenoma, parathyroid hyperplasia in patients with secondary hyperparathyroidism hitherto is difficult to assess with any imaging modality. Our case of a young patient with chronic kidney failure illustrates that F-fluorocholine PET/MR might be an imaging tool suitable for the diagnosis and presurgical assessment of parathyroid hyperplasia.

show abstract

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

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

Cited by 145 publications

References 15 publications

Preoperative imaging for focused parathyroidectomy: making a good strategy even better

Preoperative imaging for focused parathyroidectomy: making a good strategy even better

Semi-quantitative method for the assessment of focal lesions in parathyroid scintigraphy with relation to histopathology: a prospective study

Visualization of Parathyroid Hyperplasia Using 18F-Fluorocholine PET/MR in a Patient With Secondary Hyperparathyroidism

Contact Info

Product

Resources

About