July - September 2022, Volume 18, Issue 3

Yildiz R, San H, Alagoz E

Diagnostic Performances of 18f-Fluorocholine Positron Emission Tomography-Computed Tomography and Repeated Ultrasonography in Detecting Undefined Lesions in Patients with an Indication For Primary Hyperparathyroidism Surgery

Acta Endo (Buc) 2022, 18 (3): 316-323
doi: 10.4183/aeb.2022.316

Context. 18F-fluorocholine (FCH) has been used as a positron emission tomography (PET) tracer in the localization of hyper-functioning parathyroid glands (HPGs). Objective. We performed this methodological study to evaluate the diagnostic performance of 18F-FCH PET/computerized tomography (CT) and repeated ultrasonography (USG) in detecting unidentified lesions in patients with primary hyperparathyroidism (PHPT). Design. In this retrospective methodological study, we studied the diagnostic performance of 18F-FCH PET/CT and a repeated USG in detecting unidentified parathyroid lesions. Subjects and Methods. Twenty-eight patients who were diagnosed with PHPT, had an indication for surgery following the current guidelines and had no identified lesion on 99mTc-MIBI SPECT/CT, USG, or other imaging methods than 18F-FCH PET/CT, included in the study. Results. While lesions were detected in 26 patients via 18F-FCH PET/CT among 28 patients [92.9% (95% CI: 76.6%-99.1%)], the lesion detection rate was 95.7% (95% CI: 78.1%-99.9%) in 23 patients who underwent a repeated USG. The sensitivity and the accuracy of both 18F-FCH PET/CT and repeated USG were 95.2% (95% CI: 76.2%- 99.9%) and 95.0 (95% CI: 75.1%-99.9%), respectively. Conclusions. This study supports that the combination of 18F-FCH PET/CT and repeated USG has promising potential for being an imaging technique for early detection and localization of HPGs.

Keywords: 18F-Fluorocholine Positron Emission Tomography/Computerized Tomography, Hyperfunctioning Parathyroid Gland, Primary Hyperparathyroidism, Radioguided Occult Lesion Localization-Minimally Invasive Parathyroidectomy.

Correspondence: Ramazan Yildiz MD, Memorial Ankara Hospital, Department of General Surgery, Balgat Mah, Mevlana Bulv, 1422 Sk. No: 4, 06520 Çankaya/Ankara/Turkey, E-mail: mdryildiz@yahoo.com