Wiener medizinische Wochenschrift | 2019
[Imaging of parathyroid adenomas with F‑18 choline PET-CT].
Abstract
BACKGROUND\nUltrasound and sestamibi scintigraphy are the recommended standard procedures for initial diagnosis in primary hyperparathyroidism (pHPT). Recently, F‑18 choline positron emission tomography computed tomography (choline PET/CT) has been shown promising results for the diagnostic work up of primary hyperparathyroidism (pHPT) suggesting superiority over conventional scintigraphy using Tc99m sestamibi based protocols using planar dual-phase imaging, SPECT or SPECT/CT.\n\n\nMETHODS\nThis review presents the results of F‑18 choline PET/CT on the basis of a\xa0literature search using the keywords primary hyperparathyroidism and choline , primary hyperparathyroidism and PET , parathyroid adenoma and choline und parathyroid adenoma and PET .\n\n\nRESULTS\n6\xa0studies were identified dealing with the diagnostic impact of choline PET/CT. The studies included 5 to 151 patients. Localization of single gland adenomas can be achieved with choline PET/CT in 80 up to 96% of cases. A\xa0high sensitivity and accuracy of choline PET/CT imaging is documented even in cases of repeated surgery for recurrent pHPT, in coexistant nodular goiter or in the detection of adenoma in atypical localization.\n\n\nCONCLUSIONS\nUsing choline PET/CT parathyroid adenoma and probably parathyroid hyperplasia can be exactly localized in most patients with pHPT. Thus, a\xa0minimal-invasive surgical procedure is feasible with decreased risk of complications but high success rate in terms of biochemical cure. The diagnostic accuracy in multiglandular disease remains to be established.