[18F]Fluorocholine Uptake of Parathyroid Adenoma Is Correlated with Parathyroid Hormone Level
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The aim of the study was to investigate the relationship between [18F]fluoromethyl-dimethyl-2-hydroxyethylammonium ([18F]FCh) positron emission tomography (PET) parameters, laboratory parameters, and postoperative histopathological results in patients with primary hyperparathyroidism (pHPT) due to parathyroid adenomas.
This retrospective study was conducted in 52 patients with biochemically proven pHPT. [18F]FCh-PET parameters (maximum standardized uptake value: SUVmax) in early phase (after 2 min) and late phase (after 50 min), metabolic volume, and adenoma-to-background ratio (ABR), preoperative laboratory results (PTH and serum calcium concentration), and postoperative histopathology (location, size, volume, and weight of adenoma) were assessed. Relationship of PET parameters, laboratory parameters, and histopathological parameters was assessed using the Mann-Whitney U test and Spearman correlation coefficient. MRI characteristics of parathyroid adenomas were also analyzed.
The majority of patients underwent a PET/MR scan, 42 patients (80.7 %); 10 patients (19.3 %) underwent PET/CT. We found a strong positive correlation between late-phase SUVmax and preoperative PTH level (r = 0.768, p < 0.001) and between late-phase ABR and preoperative PTH level (r = 0.680, p < 0.001). The surgical specimen volume was positively correlated with the PET/MR lesion volume (r = 0.659, p < 0.001). No significant association was observed between other [18F]FCh-PET parameters, laboratory parameters, and histopathological findings. Cystic adenomas were larger than non-cystic adenomas (p = 0.048).
[18F]FCh uptake of parathyroid adenomas is strongly correlated with preoperative PTH serum concentration. Therefore, the preoperative PTH level might potentially be able to predict success of [18F]FCh-PET imaging in hyperparathyroidism, with higher lesion-to-background ratios being expected in patients with high PTH. PET/MR is accurate in estimating the volume of parathyroid adenomas.
Key Words[18F]Fluorocholine Hyperparathyroidism Parathyroid adenoma Parathyroid hormone PET/CT PET/MRI
Compliance with Ethical Standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Conflict of Interest
M.W.H. received speaker’s fees from GE Healthcare. The institution of M.W.H. received grants from GE Healthcare. All other authors declare no potential conflicts of interest.
- 5.Kelly H, Hamberg L, Hunter G (2014) 4D-CT for preoperative localization of abnormal parathyroid glands in patients with hyperparathyroidism: accuracy and ability to stratify patients by unilateral versus bilateral disease in surgery-naive and re-exploration patients. Am J Neuroradiol 35:176–181CrossRefPubMedGoogle Scholar
- 13.Huber GF, Hüllner M, Schmid C, Brunner A, Sah B, Vetter D, Kaufmann PA, von Schulthess GK (2018) Benefit of 18F-fluorocholine PET-imaging in parathyroid surgery. Eur Radiol. https://www.ncbi.nlm.nih.gov/pubmed/29372312
- 16.Michaud L, Balogova S, Burgess A et al (2015) A pilot comparison of 18F-fluorocholine PET/CT, ultrasonography and 123I/99mTc-sestaMIBI dual-phase dual-isotope scintigraphy in the preoperative localization of hyperfunctioning parathyroid glands in primary or secondary hyperparathyroidism: influence of thyroid anomalies. Medicine 94:e1701CrossRefPubMedPubMedCentralGoogle Scholar
- 19.Giovacchini G, Picchio M, Coradeschi E, Bettinardi V, Gianolli L, Scattoni V, Cozzarini C, di Muzio N, Rigatti P, Fazio F, Messa C (2010) Predictive factors of [11C]choline PET/CT in patients with biochemical failure after radical prostatectomy. Eur J Nucl Med Mol Imaging 37:301–309CrossRefPubMedGoogle Scholar
- 22.Oprea-Lager DE, Vincent AD, van Moorselaar RJ et al (2012) Dual-phase PET-CT to differentiate [18F]fluoromethylcholine uptake in reactive and malignant lymph nodes in patients with prostate cancer. PLoS One 7:–e48430Google Scholar
- 29.Protection R (2007) ICRP publication 103. Ann ICRP 37:2. https://www.ncbi.nlm.nih.gov/pubmed/18082557
- 31.Sekine T, Delso G, Zeimpekis KG, et al (2017) Reduction of 18F-FDG dose in clinical PET/MR imaging by using silicon photomultiplier detectors. Radiology:162305Google Scholar
- 38.Eiber M, Rauscher I, Souvatzoglou M et al (2017) Prospective head-to-head comparison of 11C-choline-PET/MR and 11C-choline-PET/CT for restaging of biochemical recurrent prostate cancer. Eur J Nucl Med Mol Imaging:1–10Google Scholar
- 39.Souvatzoglou M, Eiber M, Takei T, Fürst S, Maurer T, Gaertner F, Geinitz H, Drzezga A, Ziegler S, Nekolla SG, Rummeny EJ, Schwaiger M, Beer AJ (2013) Comparison of integrated whole-body [11C]choline PET/MR with PET/CT in patients with prostate cancer. Eur J Nucl Med Mol Imaging 40:1486–1499CrossRefPubMedGoogle Scholar
- 40.Iagaru A, Mittra E, Minamimoto R, Jamali M, Levin C, Quon A, Gold G, Herfkens R, Vasanawala S, Gambhir SS, Zaharchuk G (2015) Simultaneous whole-body time-of-flight 18F-FDG PET/MRI: a pilot study comparing SUVmax with PET/CT and assessment of MR image quality. Clin Nucl Med 40:1–8CrossRefPubMedGoogle Scholar