2021
DOI: 10.3390/diagnostics11122384
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18F-Fluorocholine PET and 4D-CT in Patients with Persistent and Recurrent Primary Hyperparathyroidism

Abstract: 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 patien… Show more

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Cited by 15 publications
(7 citation statements)
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“…Hence, an upfront optimized imaging for the detection and precise localization of hyperfunctioning parathyroid glands remains crucial, as the first intervention is the best time to achieve patient cure. Despite the only limited data available regarding the role of 18 F-FCH PET/CT in the reoperative setting, 18 F-FCH PET/CT appears to be a valuable technique to accurately detect hyperfunctioning parathyroid tissue in patients with persistent/recurrent pHPT and is better than 4D-CT and 99m Tc-sestamibi scintigraphy ( 11 , 24 ). In our cohort, 18 F-FCH PET/CT revealed three hyperfunctioning parathyroid hyperplasia undetected by scintigraphy in two patients with recurrent pHPT.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…Hence, an upfront optimized imaging for the detection and precise localization of hyperfunctioning parathyroid glands remains crucial, as the first intervention is the best time to achieve patient cure. Despite the only limited data available regarding the role of 18 F-FCH PET/CT in the reoperative setting, 18 F-FCH PET/CT appears to be a valuable technique to accurately detect hyperfunctioning parathyroid tissue in patients with persistent/recurrent pHPT and is better than 4D-CT and 99m Tc-sestamibi scintigraphy ( 11 , 24 ). In our cohort, 18 F-FCH PET/CT revealed three hyperfunctioning parathyroid hyperplasia undetected by scintigraphy in two patients with recurrent pHPT.…”
Section: Discussionmentioning
confidence: 99%
“…In recent years, positron emission tomography/computed tomography/computed tomography (PET/CT) with 18 F-fluorocholine ( 18 F-FCH) has emerged as second-line imaging with high resolution, low radiation exposure, and shorter examination times in patients with previously negative or inconclusive 99m Tc-sestamibi scintigraphy and/or ultrasound ( 9 ). A growing body of evidence suggests the high sensitivity of 18 F-FCH PET/CT in detecting hyperfunctioning parathyroids (sensitivity and detection rate up to 90 and 80%, respectively) in patients with pHPT ( 10 ), even in reoperated patients ( 11 ). Recently published parathyroid imaging guidelines suggest, when possible, 18 F-FCH PET/CT as a potential “alternative” first-line option in patients with pHPT ( 12 ).…”
Section: Introductionmentioning
confidence: 99%
“…Several studies have proposed preoperative localization procedures that are more sensitive to detect multiglandular disease, small lesions, or possible ectopic parathyroid tissue in MEN1-related PHPT, such as 18F-fluorocholine PET/CT (FCH-PET/CT), with or without enhanced arterial imaging, and four-dimensional computed tomography (4D-CT), especially when conventional preoperative imaging before the first intervention is inconclusive [ 19 , 20 , 21 , 22 ]. In particular, the performance of 18F-FCH-PET/CT in PHPT appears to be superior compared to commonly used imaging using 99m Tc-sestamibi scintigraphy, ultrasound, and 4D-CT [ 21 , 23 , 24 , 25 , 26 ], and provides valuable information even in cases with recurrent disease and negative or equivocal 99m Tc-sestamibi scintigraphy and/or ultrasound.…”
Section: Discussionmentioning
confidence: 99%
“…Latge et al [ 115 ] investigated the efficacy of FCH-PET/CT and 4D-CT in 43 patients with perHPT and recHPT, finding the sensitivity as 95% and 70%, detection rate as 88% and 63%, respectively, and FCH-PET/CT was found to be superior. There was no increase in sensitivity and detection rate when the two techniques were combined.…”
Section: Positron Emission Tomography (Pet) and Pet/ctmentioning
confidence: 99%