<sup>18</sup>F-fluorocholine PET/CT is more sensitive than <sup>11</sup>C-methionine PET/CT for the localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism

Mathey, Céline; Keyzer, Caroline; Blocklet, Didier; Simaeys, Gaëtan Van; Trotta, Nicola; Lacroix, Simon; Corvilain, Bernard; Goldman, Serge; Moreno‐Reyes, Rodrigo

doi:10.2967/jnumed.121.262395

Cited by 20 publications

(21 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Choline PET and 4D-CT are imaging tests that might provide superior localization in certain situations. Because previous studies have reported superior sensitivity of choline PET compared to MET-PET [57,116], choline PET could be preferred to MET-PET. PVS is an invasive technique, but it plays an important role in difficult cases such as remedial cases or those with negative imaging tests.…”

Section: Discussionmentioning

confidence: 99%

“…Parathyroid scintigraphy has been employed to detect parathyroid lesions since 57 Co-cyanocobalamine and 75 Se-selenomethionine were first used [20,21]. However, due to their poor image quality, high radiation dose, and low sensitivity, the clinical use of those radiotracers was abandoned with suboptimal results [22].…”

Section: Radionuclide Imagingmentioning

confidence: 99%

“…Compared to MET-PET/CT, 18 F-choline PET/CT was reported to be more sensitive for parathyroid localization in patients with PHPT who had negative or inconclusive 99m Tc-sestamibi-SPECT [57]. The per-patient sensitivity of 18 F-choline PET/CT and MET-PET/CT was 96% and 60%, respectively [57]. Moreover, 18 F-choline PET/CT showed comparable or superior sensitivity compared to 99m Tc-sestamibi-SPECT/CT [42,58].…”

Section: Choline Pet/ct Scansmentioning

confidence: 99%

See 2 more Smart Citations

Update on Preoperative Parathyroid Localization in Primary Hyperparathyroidism

et al. 2022

View full text Add to dashboard Cite

Parathyroidectomy is the treatment of choice for primary hyperparathyroidism when the clinical criteria are met. Although bilateral neck exploration is traditionally the standard method for surgery, minimally invasive parathyroidectomy (MIP), or focused parathyroidectomy, has been widely accepted with comparable curative outcomes. For successful MIP, accurate preoperative localization of parathyroid lesions is essential. However, no consensus exists on the optimal approach for localization. Currently, ultrasonography and technetium-99m-sestamibi–single photon emission computed tomography/computed tomography are widely accepted in most cases. However, exact localization cannot always be achieved, especially in cases with multiglandular disease, ectopic glands, recurrent disease, and normocalcemic primary hyperparathyroidism. Therefore, new modalities for preoperative localization have been developed and evaluated. Positron emission tomography/computed tomography and parathyroid venous sampling have demonstrated improvements in sensitivity and accuracy. Both anatomical and functional information can be obtained by combining these methods. As each approach has its advantages and disadvantages, the localization study should be deliberately chosen based on each patient’s clinical profile, costs, radiation exposure, and the availability of experienced experts. In this review, we summarize various methods for the localization of hyperfunctioning parathyroid tissues in primary hyperparathyroidism.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Radionuclide Imagingmentioning

confidence: 99%

Section: Choline Pet/ct Scansmentioning

confidence: 99%

See 1 more Smart Citation

Update on Preoperative Parathyroid Localization in Primary Hyperparathyroidism

et al. 2022

View full text Add to dashboard Cite

show abstract

“…An alternative PET/CT tracer for the imaging of parathyroid adenoma is 11 C-Methionine, which has been used for the detection of parathyroid adenoma. However, several studies have shown the superiority of 18 F-Fluorocholine with increased accuracy and sensitivity, which results in a higher detection rate [ 35 , 36 ]. In addition, the use of 11 C-Methionine is restricted due to a very short half-life of only 20.38 min and required on-site production.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the use of 11 C-Methionine is restricted due to a very short half-life of only 20.38 min and required on-site production. A direct performance study between 18 F-Fluorocholine and 11 C-Methionine concluded a better performance of 18 F-Fluorocholine, allowing the localization of parathyroid adenoma in 96% of patients [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Preoperative Imaging with [18F]-Fluorocholine PET/CT in Primary Hyperparathyroidism

Dekorsy

Beyer

Spitzweg

et al. 2022

JCM

View full text Add to dashboard Cite

Primary hyperparathyroidism (pHPT) is a common endocrine disorder due to hyperfunctioning parathyroid glands. To date, the only curing therapy is surgical removal of the dysfunctional gland, making correct detection and localization crucial in order to perform a minimally invasive parathyroidectomy. 18F-Fluorocholine positron emission tomography/computed tomography (18F-FCH PET/CT) has shown promising results for the detection of pHPT, suggesting superiority over conventional imaging with ultrasounds or scintigraphy. A total of 33 patients with pHPT who had negative or equivocal findings in conventional imaging received 18F-FCH PET/CT preoperatively and were retrospectively included. A pathological hyperfunctional parathyroid gland was diagnosed in 24 cases (positive PET, 72.7%), 4 cases showed equivocal choline uptake (equivocal PET, 12.1%), and in 5 cases, no enhanced choline uptake was evident (negative PET, 15.2%). Twelve of the twenty-four detected adenoma patients underwent surgery, and in all cases, a pathological parathyroid adenoma was resected at the site detected by PET/CT. Two of the six patients without pathological choline uptake who received a parathyroidectomy revealed no evidence of parathyroid adenoma tissue in the histopathological evaluation. This retrospective study analyzes 18F-FCH PET/CT in a challenging patient cohort with pHPT and negative or equivocal conventional imaging results and supports the use of 18F-FCH for the diagnosis of hyperfunctional parathyroid tissue, especially in this patient setting, with a 100% true positive and true negative detection rate. Our study further demonstrates the importance of 18F-FCH PET/CT for successful surgical guidance.

show abstract

Head-to-head comparison of [11C]methionine PET, [11C]choline PET, and 4-dimensional CT as second-line scans for detection of parathyroid adenomas in primary hyperparathyroidism

Noltes,

Kruijff,

Appelman

et al. 2023

Eur J Nucl Med Mol Imaging

View full text Add to dashboard Cite

Purpose Accurate preoperative localization is imperative to guide surgery in primary hyperparathyroidism (pHPT). It remains unclear which second-line imaging technique is most effective after negative first-line imaging. In this study, we compare the diagnostic effectiveness of [11C]methionine PET/CT, [11C]choline PET/CT, and four dimensional (4D)-CT head-to-head in patients with pHPT, to explore which of these imaging techniques to use as a second-line scan. Methods We conducted a powered, prospective, blinded cohort study in patients with biochemically proven pHPT and prior negative or discordant first-line imaging consisting of ultrasonography and 99mTc-sestamibi. All patients underwent [11C]methionine PET/CT, [11C]choline PET/CT, and 4D-CT. At first, all scans were interpreted by a nuclear medicine physician, and a radiologist who were blinded from patient data and all imaging results. Next, a non-blinded scan reading was performed. The scan results were correlated with surgical and histopathological findings. Serum calcium values at least 6 months after surgery were used as gold standard for curation of HPT. Results A total of 32 patients were included in the study. With blinded evaluation, [11C]choline PET/CT was positive in 28 patients (88%), [11C]methionine PET/CT in 23 (72%), and 4D-CT in 15 patients (47%), respectively. In total, 30 patients have undergone surgery and 32 parathyroid lesions were histologically confirmed as parathyroid adenomas. Based on the blinded evaluation, lesion-based sensitivity of [11C]choline PET/CT, [11C]methionine PET/CT, and 4D-CT was respectively 85%, 67%, and 39%. The sensitivity of [11C]choline PET/CT differed significantly from that of [11C]methionine PET/CT and 4D-CT (p = 0.031 and p < 0.0005, respectively). Conclusion In the setting of pHPT with negative first-line imaging, [11C]choline PET/CT is superior to [11C]methionine PET/CT and 4D-CT in localizing parathyroid adenomas, allowing correct localization in 85% of adenomas. Further studies are needed to determine cost–benefit and efficacy of these scans, including the timing of these scans as first- or second-line imaging techniques.

show abstract

¹⁸F-fluorocholine PET/CT is more sensitive than ¹¹C-methionine PET/CT for the localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism

Cited by 20 publications

References 23 publications

Update on Preoperative Parathyroid Localization in Primary Hyperparathyroidism

Update on Preoperative Parathyroid Localization in Primary Hyperparathyroidism

Preoperative Imaging with [18F]-Fluorocholine PET/CT in Primary Hyperparathyroidism

Head-to-head comparison of [11C]methionine PET, [11C]choline PET, and 4-dimensional CT as second-line scans for detection of parathyroid adenomas in primary hyperparathyroidism

Contact Info

Product

Resources

About

18F-fluorocholine PET/CT is more sensitive than 11C-methionine PET/CT for the localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism

Cited by 20 publications

References 23 publications

Update on Preoperative Parathyroid Localization in Primary Hyperparathyroidism

Update on Preoperative Parathyroid Localization in Primary Hyperparathyroidism

Preoperative Imaging with [18F]-Fluorocholine PET/CT in Primary Hyperparathyroidism

Head-to-head comparison of [11C]methionine PET, [11C]choline PET, and 4-dimensional CT as second-line scans for detection of parathyroid adenomas in primary hyperparathyroidism

Contact Info

Product

Resources

About

¹⁸F-fluorocholine PET/CT is more sensitive than ¹¹C-methionine PET/CT for the localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism