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01-02-2021 | Ultrasound | Review

Will ¹⁸F-fluorocholine PET/CT replace other methods of preoperative parathyroid imaging?

Authors: Luca Giovanella, Lorenzo Bacigalupo, Giorgio Treglia, Arnoldo Piccardo

Published in: Endocrine | Issue 2/2021

Abstract

Introduction

Primary hyperparathyroidism (PHPT) is a common endocrine disorder usually due to hyperfunctioning parathyroid glands (HPs). Surgical removal of the HPs is the main treatment for PHPT, making the correct detection and localization of HPs crucial to guiding targeted and minimally invasive surgical treatment in patients with PHPT. To date, different imaging methods have been used to detect and localize HPs, including radiology, nuclear medicine, and hybrid techniques.

Methods

The present work discusses the role and value of different imaging methods in PHPT and, particularly, evaluates the potential role of ¹⁸F-fluorcholine PET/CT as a “one-stop-shop” method for preoperative parathyroid localization in patients with PHPT.

Discussion

Cervical ultrasound (US) and parathyroid scintigraphy using ^99mTc-MIBI are the most commonly employed methods in clinical practice. More recently, four-dimensional computed tomography (4D CT) and positron emission tomography (PET) with radiolabeled choline have emerged as useful alternatives in cases of negative or discordant findings from first-line imaging methods.

Conclusions

Due to the excellent diagnostic performance of radiolabeled choline PET/CT and the low radiation burden, this technique seems to be an ideal candidate to substitute current imaging procedures including US, MIBI scintigraphy, 4D CT and MRI and perform a fast and reliable “one-stop-shop” preoperative localization of HP in patients with PHPT, including challenging cases of postoperative persistent/recurrent disease.

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Title: Will 18F-fluorocholine PET/CT replace other methods of preoperative parathyroid imaging?
Authors: Luca Giovanella
Lorenzo Bacigalupo
Giorgio Treglia
Arnoldo Piccardo
Publication date: 01-02-2021
Publisher: Springer US
Keywords: Ultrasound
Hyperparathyroidism
Ultrasound
Positron Emission Tomography
Scintigraphy
Published in: Endocrine / Issue 2/2021
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI: https://doi.org/10.1007/s12020-020-02487-y

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