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

Diagnostics ◽  
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.

scholarly journals An Unusual Case of Primary Hyperparathyroidism: Case Report of a Bifocal Intrathyroidal Parathyroid Carcinoma

2020 ◽  
pp. 014556132097746
Author(s):  
Maxime Damien ◽  
Alexandra Rodriguez ◽  
Pierre Kleynen ◽  
Didier Dequanter ◽  
Cyril Bouland
Keyword(s):  
Computed Tomography ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Carcinoma ◽  
Photon Emission ◽  
Parathyroid Tissue ◽  
Emission Computed Tomography ◽  
Thyroid Lobe ◽  
Imaging Results ◽  
Pet Ct ◽  
Left Thyroid Lobe

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.

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

2014 ◽  
Vol 41 (11) ◽  
pp. 2083-2089 ◽  
Author(s):  
Luka Lezaic ◽  
Sebastijan Rep ◽  
Mojca Jensterle Sever ◽  
Tomaz Kocjan ◽  
Marko Hocevar ◽  
...  
Keyword(s):  
Pilot Study ◽  
Primary Hyperparathyroidism ◽  
Parathyroid Tissue ◽  
Pet Ct

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

2015 ◽  
Vol 49 (4) ◽  
pp. 327-333 ◽  
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.

scholarly journals 18F-Fluorocholine PET and Multiphase CT Integrated in Dual Modality PET/4D-CT for Preoperative Evaluation of Primary Hyperparathyroidism

2020 ◽  
Vol 9 (6) ◽  
pp. 2005
Author(s):  
Valentin Pretet ◽  
Marianela Rotania ◽  
Mehdi Helali ◽  
Mihaela Ignat ◽  
Michel Vix ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Preoperative Evaluation ◽  
High Serum ◽  
Additional Patient ◽  
Second Line ◽  
4D Ct ◽  
Pet Ct ◽  
Line Imaging ◽  
Preoperative Work Up ◽  
Work Up

The present retrospective study evaluates the diagnostic value of integrated 18F-Fluorocholine positron emission tomography/four-dimensional contrast-enhanced computed tomography (18F-FCH PET/4D-CT) as second-line imaging in preoperative work-up of primary hyperparathyroidism (pHPT), and compares 18F-FCH PET with 4D-CT. Patients with pHPT and negative/discordant first-line imaging addressed for integrated 18F-FCH PET/4D-CT were retrospectively selected. Sensitivity and detection rate (DR%) of 18F-FCH PET/CT, 4D-CT, and PET/4D-CT were calculated according to the per patient and per lesion analyses, and afterwards compared. Histology associated with a decrease more than 50% of perioperative parathyroid hormone (PTH) blood level was used as a gold standard. Persistent high serum PTH and calcium levels during a 6-month follow-up was considered as presence of pHPT in both operated and non-operated patients. 50 patients (55 glands) were included. 44/50 patients (88%) were surgically treated. On a per patient analysis, sensitivity was 93%, 80%, and 95%, and DR% was 82%, 68%, and 84%, respectively for PET/CT, 4D-CT, and PET/4D-CT. PET/CT was more sensitive than 4D-CT (p = 0.046). PET/4D-CT performed better than 4D-CT (p = 0.013) but was equivalent to PET/CT alone. On a per gland analysis, sensitivity PET/CT, 4D-CT, and PET/4D-CT was 88%, 66%, and 92%, and DR% was 79%, 57%, and 83%, respectively. PET/CT and PET/4D-CT were more sensitive than 4D-CT alone (p = 0.01, p < 0.001, respectively). However, PET/CT and PET/4D-CT performed similarly. In conclusion, 18F-FCH PET provides better identification of hyperfunctioning parathyroids than 4D-CT and the combination of both did not significantly improve diagnostic sensitivity. Further investigations involving larger populations are necessary to define the role of 18F-FCH PET/4D-CT as a “one-stop shop” second-line imaging in preoperative work-up of pHPT, especially considering the additional patient radiation exposure due to multi-phase CT.

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

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

Bewegungsadaptierte Schwächungskorrektur mit Averaging-CT und 4D-CT im 4D PET-CT der Lunge

2012 ◽  
Vol 184 (12) ◽  
Author(s):  
M Baier ◽  
M Ullrich ◽  
J Dinkel ◽  
F Schoenahl ◽  
U Lützen ◽  
...  
Keyword(s):  
4D Ct ◽  
Pet Ct

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

1974 ◽  
Vol 75 (2) ◽  
pp. 286-296 ◽  
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.

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

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
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