Naslov
The value of PET/CT in patients with primary hyperparathyroidism and negative or inconclusive neck ultrasound and MIBI scintigraphy

Autori
Huic, Drazen ; Golubic, Anja Tea ; Pasini Nemir, Eva

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, ostalo

Izvornik
Abstracts of 33rd Annual Congress of the European- Association-of-Nuclear-Medicine (EANM) / - , 2020, 136-136

Skup
33rd Annual Congress of the European Association of Nuclear Medicine (EANM)

Mjesto i datum
Beč, Austrija; online, 22.10.2020. - 30.10.2020

Vrsta sudjelovanja
Predavanje

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
F-18-choline ; PET/CT ; PHP ; parathyroid glands

Sažetak
Aim/Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine disorder and parathyroid surgery still represents the only curative approach. Preoperative localization of hyperfunctioning parathyroid glands is very challenging, but it is crucial for focused and minimally invasive parathyroid surgery. The aim of our study was to assess the value of 18F- fluorocholine positron emission tomography (PET/CT) in very selected group of patients with negative or inconclusive neck ultrasound and MIBI scintigraphy and history of hyperparathyroidism of several years. Materials and Methods: We performed PET/CT with 100-150 MBq of 18F-fluorocholine in 42 patients (female 36, male 6, mean age 57years) in 18 months’ period. Lowdose PET/CT acquisition was done 15-30 minutes’ post injection. The regions of neck and thorax were scanned, 3 min per bed position. Results: In 40 patients (95%) 42 foci of increased tracer uptake suggestive for hyperactive parathyroid gland have been found, single in 38 patients, and two in two patients. One patient was negative and the other one judged as false positive after surgery. Most often localisation of the hyperactive parathyroid gland in the neck region was in the level of the lower pole of thyroid lobe (11 on the right side, 10 on the left. Less common we found lesions in the level of the upper pole of thyroid lobe (7 right, 5 left). Usually parathyroid glands in the neck were localised very deeply prevertebral. In 8 patients (19%) we found ectopic parathyroid gland in mediastinum. The average maximum diameter of the lesions was 8 mm (range 4-30 mm), and median SUV value was 6 (range 2- 10, 6). 17 patients underwent surgery, and 18 parathyroid glands were removed. Pathology confirmed parathyroid hyperplasia in 13 glands and adenoma in 5 cases. The mean PTH and Ca serum values postoperatively dropped significantly (PTH from 19, 1 to 6 pmol/L ; Ca from 2, 8 to 2, 4 mmol/L), and normalized in all patients. Conclusion: In conclusion, PET/CT with 18F-fluorocholine is very sensitive and simple method for localisation of hyperactive parathyroid glands in very demanding patients with the long history of primary hyperparathyroidism. The data about specificity will be more detailed when surgery will be completed in majority of our patients. References

Izvorni jezik
Engleski

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