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

  • Luka LezaicEmail author
  • Sebastijan Rep
  • Mojca Jensterle Sever
  • Tomaz Kocjan
  • Marko Hocevar
  • Jure Fettich
Original Article

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.

Keywords

18F-Fluorocholine Hyperparathyroidism PET/CT 

Notes

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Luka Lezaic
    • 1
    Email author
  • Sebastijan Rep
    • 1
  • Mojca Jensterle Sever
    • 2
  • Tomaz Kocjan
    • 2
  • Marko Hocevar
    • 3
  • Jure Fettich
    • 1
  1. 1.Department for Nuclear MedicineUniversity Medical Centre LjubljanaLjubljanaSlovenia
  2. 2.Department of Endocrinology, Diabetes and Metabolic DiseasesUniversity Medical Centre LjubljanaLjubljanaSlovenia
  3. 3.Department of Surgical OncologyInstitute of OncologyLjubljanaSlovenia

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