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

Intrathyroidal parathyroid carcinoma is an extremely rare cause of primary hyperparathyroidism. We reported a 51-year old woman who presented symptoms of hypercalcemia. 99mTc sestamibi single-photon emission computed tomography/computed tomography (CT) revealed a large hypermetabolic nodule in the left thyroid lobe suggestive of hyperfunctioning parathyroid tissue. 11C-methionine positron emission tomography/computed tomography (PET/CT) and 18F-fluorocholine PET/CT confirmed the nodule in the left thyroid lobe and also revealed a hypermetabolic activity on the posterior surface of the lower left pole. The patient underwent a total thyroidectomy and parathyroidectomy, and a diagnosis of bifocal intrathyroidal parathyroid carcinoma was confirmed. We present the first reported case of bifocal intrathyroidal carcinoma and discuss the discordant imaging results.

Download Full-text

Optimal scan time for evaluation of parathyroid adenoma with [18F]-fluorocholine PET/CT

Radiology and Oncology ◽

10.1515/raon-2015-0016 ◽

2015 ◽

Vol 49 (4) ◽

pp. 327-333 ◽

Cited By ~ 24

Author(s):

Sebastijan Rep ◽

Luka Lezaic ◽

Tomaz Kocjan ◽

Marija Pfeifer ◽

Mojca Jensterle Sever ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Retention Index ◽

Cellular Proliferation ◽

Thyroid Tissue ◽

Parathyroid Tissue ◽

Second Phase ◽

The Third ◽

Third Phase ◽

Scan Time ◽

Pet Ct

Abstract Background. Parathyroid adenomas, the most common cause of primary hyperparathyroidism, are benign tumours which autonomously produce and secrete parathyroid hormone. [18F]-fluorocholine (FCH), PET marker of cellular proliferation, was recently demonstrated to accumulate in lesions representing enlarged parathyroid tissue; however, the optimal time to perform FCH PET/CT after FCH administration is not known. The aim of this study was to determine the optimal scan time of FCH PET/CT in patients with primary hyperparathyroidism. Patients and methods. 43 patients with primary hyperparathyroidism were enrolled in this study. A triple-phase PET/CT imaging was performed five minutes, one and two hours after the administration of FCH. Regions of interest (ROI) were placed in lesions representing enlarged parathyroid tissue and thyroid tissue. Standardized uptake value (SUVmean), retention index and lesion contrast for parathyroid and thyroid tissue were calculated. Results. Accumulation of FCH was higher in lesions representing enlarged parathyroid tissue in comparison to the thyroid tissue with significantly higher SUVmean in the second and in the third phase (p < 0.0001). Average retention index decreased significantly between the first and the second phase and increased significantly between the second and the third phase in lesions representing enlarged parathyroid tissue and decreased significantly over all three phases in thyroid tissue (p< 0.0001). The lesion contrast of lesions representing enlarged parathyroid tissue and thyroid tissue was significantly better in the second and the third phase compared to the first phase (p < 0.05). Conclusions. According to the results the optimal scan time of FCH PET/CT for localization of lesions representing enlarged parathyroid tissue is one hour after administration of the FCH.

Download Full-text

18F-Fluorocholine PET and 4D-CT in Patients with Persistent and Recurrent Primary Hyperparathyroidism

Diagnostics ◽

10.3390/diagnostics11122384 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2384

Author(s):

Adrien Latge ◽

Sophie Riehm ◽

Michel Vix ◽

Jacob Bani ◽

Mihaela Ignat ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Detection Rate ◽

Parathyroid Tissue ◽

Dynamic Ct ◽

Surgical Guidance ◽

4D Ct ◽

Surgical Success ◽

Pet Ct ◽

Higher Sensitivity ◽

Better Than

Patients with primary hyperparathyroidism (pHPT) can develop persistent (P-pHPT) or recurrent (R-pHPT) disease after parathyroidectomy. Before recommending reoperation, recurrence must be accurately identified because of the high risk of complications. Our study evaluates 18F-fluorocholine (18F-FCH) PET/CT and 4D-CT integrated in PET/4D-CT in patients with P-pHPT/R-pHPT. Patients with P-pHPT/R-pHPT investigated by 18F-FCH PET/4D-CT between May 2018 and March 2021 were retrospectively included. Forty-two patients were included, 37 of whom underwent 4D-CT. The sensitivity and detection rate (DR%) were 95% and 88% for 18F-FCH PET/CT and 70% and 63% for 4D-CT, respectively. PET/CT and 4D-CT were concordant in 18/24 glands and concordant and positive in 15/24 (63%) glands. Discordant results were obtained for 6/24 glands. The surgical success rate was 65%. PET/CT showed significantly higher sensitivity than 4D-CT. Dynamic CT allowed the identification of no additional glands missed by PET/CT, and the combination of the 2 techniques did not improve the sensitivity or DR%. 18F-FCH PET/CT appears to be a valuable technique to accurately detect hyperfunctioning parathyroid tissue in patients with P-pHPT/R-pHPT and is better than 4D-CT. Except for cases with doubtful locations of PET targets that may require 4D-CT for surgical guidance, standard nonenhanced 18F-FCH PET/CT can be effectively recommended in patients with P-pHPT/R-pHPT before reoperation.

Download Full-text

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

Journal of Nuclear Medicine ◽

10.2967/jnumed.121.262395 ◽

2021 ◽

pp. jnumed.121.262395

Author(s):

Céline Mathey ◽

Caroline Keyzer ◽

Didier Blocklet ◽

Gaetan Van Simaeys ◽

Nicola Trotta ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Parathyroid Tissue ◽

Pet Ct

Download Full-text

PARATHYROID HORMONE SECRETION IN DISORDERS OF CALCIUM METABOLISM STUDIED BY MEANS OF EDTA

Acta Endocrinologica ◽

10.1530/acta.0.0750286 ◽

1974 ◽

Vol 75 (2) ◽

pp. 286-296 ◽

Cited By ~ 10

Author(s):

J. H. Lockefeer ◽

W. H. L. Hackeng ◽

J. C. Birkenhäger

Keyword(s):

Parathyroid Hormone ◽

Primary Hyperparathyroidism ◽

Calcium Metabolism ◽

Hormone Secretion ◽

Parathyroid Tissue ◽

Small Mass ◽

Idiopathic Hypercalciuria ◽

List Type ◽

Immunoreactive Parathyroid Hormone ◽

Pth Level

ABSTRACT In 22 of 28 cases of primary hyperparathyroidism (PHP) the rise in the serum immunoreactive parathyroid hormone (IRPTH or PTH) level observed in response to lowering of the serum calcium by EDTA, exceeded that obtained in 8 control subjects. In 5 of these 22 patients who were studied again after parathyroidectomy the supranormal response was abolished. Fifteen of these 22 hyper-responsive PHP patients had basal IRPTH levels not exceeding the highest level in the controls and that of other groups of patients investigated (idiopathic hypercalciuria, non-parathyroid hypercalcaemia, operated PHP). Fourteen of the 22 hyper-reactive patients with PHP did not show hypocalcaemia during the infusion of EDTA. The extent of the release of PTH elicited by EDTA in cases of PHP does not as yet allow a prediction of the amount of pathological parathyroid tissue present, although all the PHP patients showing a normal release of PTH had a relatively small mass of parathyroid tissue (up to about 1 g) subsequently removed. In 9 cases of nephrolithiasis (8 of whom had idiopathic hypercalciuria) and in 7 cases of non-parathyroid hypercalcaemia, a normal PTH release was found.

Download Full-text

18Fluoro-choline PET/CT is a useful tool for patients with primary hyperparathyroidism negative at first-line imaging localization tecniques

Endocrine Abstracts ◽

10.1530/endoabs.70.aep207 ◽

2020 ◽

Author(s):

Matteo Apicella ◽

Stefano Bola ◽

Duccio Volterrani ◽

Laura Mazoni ◽

Gianluca Frustaci ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

First Line ◽

Choline Pet ◽

Pet Ct ◽

Line Imaging

Download Full-text

Faculty Opinions recommendation of Systemic and vascular inflammation in patients with moderate to severe psoriasis as measured by [18F]-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT): a pilot study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.11270956.13289056 ◽

2011 ◽

Author(s):

Johann Gudjonsson ◽

Abhishek Aphale

Keyword(s):

Computed Tomography ◽

Positron Emission Tomography ◽

Pilot Study ◽

Vascular Inflammation ◽

Emission Tomography ◽

Fluorodeoxyglucose Positron Emission Tomography ◽

Positron Emission ◽

Pet Ct ◽

Fdg Pet Ct ◽

Fluorodeoxyglucose Positron Emission

Download Full-text

Head and neck tumors angiogenesis imaging with 68Ga-NODAGA-RGD in comparison to 18F-FDG PET/CT: a pilot study

EJNMMI Research ◽

10.1186/s13550-020-00638-w ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Steve Durante ◽

Vincent Dunet ◽

François Gorostidi ◽

Periklis Mitsakis ◽

Niklaus Schaefer ◽

...

Keyword(s):

Pilot Study ◽

Head And Neck ◽

Fdg Pet ◽

Head And Neck Tumors ◽

Neck Tumors ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

Download Full-text

Bone and Mineral Metabolism Phenotypes in MEN1-Related and Sporadic Primary Hyperparathyroidism, before and after Parathyroidectomy

Cells ◽

10.3390/cells10081895 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1895

Author(s):

Francesca Marini ◽

Francesca Giusti ◽

Federica Cioppi ◽

Davide Maraghelli ◽

Tiziana Cavalli ◽

...

Keyword(s):

Primary Hyperparathyroidism ◽

Bone Mass ◽

Bone Metabolism ◽

Mineral Metabolism ◽

Parathyroid Tissue ◽

Young Patients ◽

Surgical Removal ◽

Mineral Density ◽

Bone Mass Loss ◽

Before And After

Primary hyperparathyroidism (PHPT) is the most common endocrinopathy in multiple endocrine neoplasia type 1 (MEN1). Persistent levels of increased parathyroid hormone (PTH) result in a higher incidence of osteopenia and osteoporosis compared to the general population. Surgical removal of hyper-functioning parathyroid tissue is the therapy of choice. This retrospective study evaluated the effect of parathyroidectomy (PTX) on bone metabolism and bone mass in two series of patients with MEN1 PHPT and sporadic PHPT (sPHPT) by comparing bone metabolism-related biochemical markers and bone mineral density (BMD) before and after surgery. Our data confirmed, in a higher number of cases than in previously published studies, the efficacy of PTX, not only to rapidly restore normal levels of PTH and calcium, but also to normalize biochemical parameters of bone resorption and bone formation, and to improve spine and femur bone mass, in both MEN1 PHPT and sPHPT. Evaluation of single-patient BMD changes after surgery indicates an individual variable bone mass improvement in a great majority of MEN1 PHPT patients. In MEN1 patients, PTX is strongly suggested in the presence of increased PTH and hypercalcemia to prevent/reduce the early-onset bone mass loss and grant, in young patients, the achievement of the bone mass peak; routine monitoring of bone metabolism and bone mass should start from adolescence. Therapy with anti-fracture drugs is indicated in MEN1 patients with BMD lower than the age-matched normal values.

Download Full-text