FDG-PET/CT and parathyroid carcinoma: Review of literature and illustrative case series

Abstract

Parathyroid cancer is an uncommon malignant cancer and is associated with a poor prognosis. The staging of parathyroid cancer represents an important issue both at initial diagnosis and after surgery and medical treatment. The role of positron emission tomography/ computed tomography (PET/CT) with 18F-Fluorodeoxyglucose (18F-FDG) as an imaging tool in parathyroid cancer is not clearly reported in the literature, although its impact in other cancers is well-defined. The aim of the following illustrative clinical cases is to highlight the impact of PET/CT in the management of different phases of parathyroid cancer. We describe five patients with parathyroid malignant lesions, who underwent FDG PET/CT at initial staging, restaging and post-surgery evaluation. In each patient we report the value of PET/ CT comparing its findings with other common imaging modalities (e.g., CT, planar scintigraphy with 99mTc-sestamibi, magnetic resonance imaging) thus determining the complementary benefit of FDG PET/CT in parathyroid carcinoma. We hope to provide an insight into the potential role of PET/CT in assessing the extent of disease and response to treatment which are the general principles used to correctly evaluate disease status.

Incidental uptake of 18F-fluorocholine (FCH) in the head or in the neck of patients with prostate cancer

“…The discovery of an incidental hyper-functioning parathyroid gland on FDG PET has been reported 26–27. FDG has been proposed to stage parathyroid carcinoma, being more aggressive than adenoma or hyperplasia 28. Discrepant results have been reported with FDG in the detection of adenoma or hyperplasia, a very low sensitivity in two short series29,30 or, in comparison with 99m Tc-SestaMIBI, a better sensitivity (86% vs .…”

Parathyroid Carcinoma

“…103 Recently, Evangelista et al evaluated the role of PET/ CT with 18F-FDG at initial staging, restaging, and postsurgical evaluation in five patients with parathyroid carcinoma. 104 The authors suggest that a PET/CT scan, despite its low sensitivity in detecting small lesions, can be considered a very sensitive imaging technique to define the extent of the disease at initial staging and identify a recurrence.…”

Clinical, laboratory and instrumental methods of pre-surgical diagnosis of the parathyroid glands cancer

“…Большая разрешающая способность изображения дает возмож-ность выявлять региональные и отдаленные метастазы исходно, исключать рецидивы и оценивать эффект проведенного лечения. Захват радио фармпрепарата опухолевыми клетками позволяет определить локализа-цию мелких образований, метастазов, диаг-ностировать рецидив заболевания [12].…”