title: Comparison of 99mTc-sestamibi and 11C-methionine PET/CT in the localization of parathyroid adenomas in primary hyperparathyroidism.
abstract: OBJECTIVE
  To evaluate the usefulness of (11)C-methionine PET/CT (MET) in the localization of the parathyroid adenomas and to compare the results with those obtained with the conventional technique in double-phase (99m)Tc-sestamibi scintigraphy (MIBI). We evaluated the optimal timing to acquire MET images.
  
  
  METHODS
  A prospective study that included 14 patients (mean age: 65.5 ± 9.7 years) with primary hyperparathyroidism (PH) who underwent surgery was performed. Mean serum iPTH was 215.8 ± 108 pg/mL and serum calcium 10.8 ± 0.9 mg/dL. MIBI (planar and SPECT) was obtained 10 min and 2-3h after injection of 740 MBq (20 mCi) of (99m)Tc-sestamibi. MET was obtained 10 min and 40 min after injection of 740 MBq (20 mCi) of (11)C-methionine. MIBI and MET images were visually evaluated and compared. A score for 10 min and 40 min MET images from 0 (no abnormal uptake) to 3 (intense uptake) was assigned.
  
  
  RESULTS
  MIBI and MET were positive and concordant in 11/14 patients and in 10 of them the parathyroid adenoma was correctly localized. In 3/14 MIBI was positive and MET negative (MIBI correctly localized the parathyroid adenoma in 2 of them). According to the timing of MET imaging acquisition, the 10 min and 40 min acquisition showed the same score in 10 patients, it was higher at 10 min acquisition in 3 and in 1 the parathyroid adenoma was only detected at 40 min acquisition.
  
  
  CONCLUSIONS
  MIBI remains the technique of choice for the localization of parathyroid adenomas in patients with PH. MET may play a complementary role in selected patients. Delayed acquisition should be included in the MET protocol when the early acquisition is negative.
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain. Electronic address: mimartinez@humv.es.
authors.forename: I
authors.initials: I
authors.lastname: Martínez-Rodríguez
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Martínez-Amador
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
authors.forename: M
authors.initials: M
authors.lastname: de Arcocha-Torres
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Quirce
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Ortega-Nava
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Ibáñez-Bravo
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Lavado-Pérez
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
authors.forename: Z
authors.initials: Z
authors.lastname: Bravo-Ferrer
authors.affiliation: Nuclear Medicine, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Santander, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Carril
mesh_terms: D000236:Adenoma / Q000150:complications* / Q000175:diagnosis*; D000368:Aged; D005260:Female; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000150:complications*; D008297:Male; D008715:Methionine; D064847:Multimodal Imaging; D010282:Parathyroid Neoplasms / Q000150:complications* / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; C086242:carbon-11 methionine; D017256:Technetium Tc 99m Sestamibi; D008715:Methionine
keywords: (11)C-methionine PET/CT; (11)C-metionina PET/TC; (99m)Tc-sestamibi scintigraphy; Adenoma de paratiroides; Cirugía mínimamente invasiva; Gammagrafía con (99m)Tc-sestamibi; Hiperparatiroidismo primario; Minimally invasive surgery; Parathyroid adenoma; Primary hyperparathyroidism