title: ¹⁸F-Fluorocholine PET/CT for localization of hyperfunctioning parathyroid tissue in primary hyperparathyroidism: a pilot study.
abstract: OBJECTIVE
  Primary hyperparathyroidism is a common endocrine disorder which is diagnosed biochemically and for which therapy is surgical. A prerequisite for minimally invasive surgery, which minimizes morbidity and cost, is accurate localization of the involved gland(s). The aim of this study was to evaluate the usefulness of (18)F-fluorocholine PET/CT for preoperative localization of hyperfunctioning parathyroid tissue.
  
  
  METHODS
  (18)F-Fluorocholine PET/CT and conventional parathyroid scintigraphic imaging consisting of (99m)Tc-sestaMIBI SPECT/CT, (99m)Tc-sestaMIBI dual-phase imaging and (99m)Tc-sestaMIBI/pertechnetate subtraction imaging were performed in 24 patients. The diagnostic performance of the imaging methods was compared against histology as the gold standard and postoperative serum Ca(2+) and iPTH values.
  
  
  RESULTS
  The sensitivity and specificity of (18)F-fluorocholine PET/CT were 92% and 100%, respectively, in contrast to 49% and 100%, 46% and 100%, and 44% and 100% for (99m)Tc-sestaMIBI SPECT/CT, (99m)Tc-sestaMIBI/pertechnetate subtraction imaging and (99m)Tc-sestaMIBI dual-phase imaging, respectively. Combined conventional scintigraphic imaging had a sensitivity and specificity of 64% and 100%, respectively. The performance of (18)F-fluorocholine PET/CT was superior particularly in patients with multiple lesions or hyperplasia.
  
  
  CONCLUSIONS
  (18)F-Fluorocholine PET/CT appears to be a promising, effective imaging method for localization of hyperfunctioning parathyroid tissue.
authors: Department for Nuclear Medicine, University Medical Centre Ljubljana, Zaloska 7, 1525, Ljubljana, Slovenia, luka.lezaic@kclj.si.
authors: Luka
authors: L
authors: Lezaic
authors: Sebastijan
authors: S
authors: Rep
authors: Mojca Jensterle
authors: MJ
authors: Sever
authors: Tomaz
authors: T
authors: Kocjan
authors: Marko
authors: M
authors: Hocevar
authors: Jure
authors: J
authors: Fettich
mesh_terms: D000328:Adult; D000368:Aged; D002794:Choline / Q000031:analogs & derivatives*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D049950:Hyperparathyroidism, Primary / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D006965:Hyperplasia / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D010280:Parathyroid Glands / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
chemical_list: C514960:fluorocholine; D002794:Choline