Additional value of integrated 18F-choline PET/4D contrast-enhanced CT in the localization of hyperfunctioning parathyroid glands and correlation with molecular profile

Abstract

Integrated F-choline PET/4DCeCT should be considered as an effective tool to detect PHPT in patients with negative or inconclusive first-line imaging. Choline metabolism is correlated with both calcium level and Ki67 expression in HPTG.

18F-choline PET/CT and PET/MRI in primary and recurrent hyperparathyroidism: a systematic review of the literature

“…In particular, Michaud et al [13] and Kluijhout et al [14] ran a single dynamic acquisition lasting 10 min and 40 min, respectively; and Michaud et al and Prabhu et al [12,15] performed a dynamic acquisition for 10-15 min followed by a static image 10 or 45 min after the injection. Static acquisitions were obtained in the other studies at a single point ranging from 10 to 60 min after the intravenous administration of FCH in 9/23 studies [4,16,17,[19][20][21][22][23]34]; and twice, first after 2-60 min and then after 60-120 min, in 10/23 studies. Only Rep et al [25] reported scanning patients 3 times, at 5, 60 and 120 min after FCH injection.…”

“…Only Rep et al [25] reported scanning patients 3 times, at 5, 60 and 120 min after FCH injection. The FCH dosage was fixed in 16 studies, in the range of 100-230 MBq [15,[19][20][21][22][23][24][25][26][27][28][31][32][33][34]; it was adjusted to the patient's body weight in 5 (1.5-3.2 MBq/kg) and not declared in two studies [12,16,17,29,30].…”

18F-Fluorocholine PET/CT in Primary Hyperparathyroidism: Superior Diagnostic Performance to Conventional Scintigraphic Imaging for Localization of Hyperfunctioning Parathyroid Glands

“…Emerging studies show a slow but steady growth of evidence establishing 18 F-fluorocholine as the most promising PET tracer investigated for localizing hyperfunctioning glands. In comparison to conventional scintigraphic imaging, ultrasonography, or in 1 case 4D CT, 18 F-fluorocholine had superior performance, with reported sensitivities ranging from 94% to 100% (6,7,14,15). Typically, 18 Ffluorocholine PET/CT was performed as a second-line investigation when conventional scintigraphic imaging had negative results, was inconclusive, or was discordant with ultrasonographic examination of the neck.…”

Preoperative Localization of Adenomas in Primary Hyperparathyroidism: The Value of 11C-Choline PET/CT in Patients with Negative or Discordant Findings on Ultrasonography and 99mTc-Sestamibi SPECT/CT

“…11 C-methionine PET/CT has been successfully applied in this setting (14)(15)(16)(17)(18). During the last few years, radiolabeled choline has been increasingly used to localize PTAs, with high sensitivities reported (19)(20)(21)(22). However, many studies were conducted on small patient cohorts.…”