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Volume 11
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10.3390/jcm11102944
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Article

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

by
Franziska J. Dekorsy
1,*,
Leonie Beyer
1,
Christine Spitzweg
2,
Ralf Schmidmaier
2,
Andrei Todica
1,
Arnold Trupka
3,
Clemens C. Cyran
4,
Frank Berger
4,
Roland Ladurner
5,6,
Petra Zimmermann
5,
Thomas Knösel
7,
Peter Bartenstein
1,
Christian Lottspeich
2 and
Vera Wenter
1
1
Department of Nuclear Medicine, University Hospital, LMU Munich, 81377 Munich, Germany
2
Department of Internal Medicine IV, University Hospital, LMU Munich, 81377 Munich, Germany
3
Department of Endocrine Surgery, Starnberg Hospital, 82319 Starnberg, Germany
4
Department of Radiology, University Hospital, LMU Munich, 81377 Munich, Germany
5
Department of Surgery, University Hospital, LMU Munich, 81377 Munich, Germany
6
Department of Surgery, Martha-Maria Krankenhaus, 81377 Munich, Germany
7
Institute of Pathology, Faculty of Medicine, University Hospital, LMU Munich, 81377 Munich, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2022, 11(10), 2944; https://doi.org/10.3390/jcm11102944
Submission received: 11 April 2022 / Revised: 19 May 2022 / Accepted: 19 May 2022 / Published: 23 May 2022
(This article belongs to the Section Nuclear Medicine & Radiology)
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Abstract

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.
Keywords: fluorocholine PET/CT; parathyroid adenoma; noninvasive imaging fluorocholine PET/CT; parathyroid adenoma; noninvasive imaging

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MDPI and ACS Style

Dekorsy, F.J.; Beyer, L.; Spitzweg, C.; Schmidmaier, R.; Todica, A.; Trupka, A.; Cyran, C.C.; Berger, F.; Ladurner, R.; Zimmermann, P.; et al. Preoperative Imaging with [18F]-Fluorocholine PET/CT in Primary Hyperparathyroidism. J. Clin. Med. 2022, 11, 2944. https://doi.org/10.3390/jcm11102944

AMA Style

Dekorsy FJ, Beyer L, Spitzweg C, Schmidmaier R, Todica A, Trupka A, Cyran CC, Berger F, Ladurner R, Zimmermann P, et al. Preoperative Imaging with [18F]-Fluorocholine PET/CT in Primary Hyperparathyroidism. Journal of Clinical Medicine. 2022; 11(10):2944. https://doi.org/10.3390/jcm11102944

Chicago/Turabian Style

Dekorsy, Franziska J., Leonie Beyer, Christine Spitzweg, Ralf Schmidmaier, Andrei Todica, Arnold Trupka, Clemens C. Cyran, Frank Berger, Roland Ladurner, Petra Zimmermann, and et al. 2022. "Preoperative Imaging with [18F]-Fluorocholine PET/CT in Primary Hyperparathyroidism" Journal of Clinical Medicine 11, no. 10: 2944. https://doi.org/10.3390/jcm11102944

APA Style

Dekorsy, F. J., Beyer, L., Spitzweg, C., Schmidmaier, R., Todica, A., Trupka, A., Cyran, C. C., Berger, F., Ladurner, R., Zimmermann, P., Knösel, T., Bartenstein, P., Lottspeich, C., & Wenter, V. (2022). Preoperative Imaging with [18F]-Fluorocholine PET/CT in Primary Hyperparathyroidism. Journal of Clinical Medicine, 11(10), 2944. https://doi.org/10.3390/jcm11102944

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