Hefez, Avi1, Masalha, Muhamed1,3, Domachevsky, Liran2, Bernstine, Hanna2, Groshar, David2, Gindi, Nichal2, Lockman, Yehudit2.
1 Department of Otolaryngology, Head and Neck Surgery, Assuta Medical Center,Tel Aviv. Affiliated with Ben Gurion University- Faculty of Medicine, Beer Seva, Israel
2 Department of Radiology, Assuta Medical Center,Tel Aviv. Affiliated with Ben Gurion University- Faculty of Medicine, Beer Seva, Israel
3 Department of Otolaryngology, Head and Neck Surgery, Emeq Medical Center. Affiliated with Technion University, Haifa, Israel
Background: Although preoperative localization of parathyroid adenoma is usually obtained by the combination of ultrasound and scintigraphy with [99mTc] methoxyisobutylisonitrile ([99mTc] MIBI), a role still exists for other localizing studies. We evaluated the role of F18- Fluorcholine (FCH) Neck PET/MR as a novel tool for localizing parathyroid adenoma.
Methods: 22 patients with primary hyperparathyroidism (18 women and four men, mean age 60±10 years) were prospectively recruited. A F18- Fluorcholine (FCH) dedicated neck PET/MR were performed. Standardized Uptake Values (SUV) and Metabolic Tumor Volume (MTV) in the parathyroid were detected and compared with uptake values of thyroid gland and the sternocleidomastoid muscle.
Results: Increased uptake of FCH in parathyroid adenomas was shown in 20 out of 22 patients (91%). The SUV measured for parathyroid adenoma was significantly higher in the parathyroid adenoma compared with the thyroid gland and the sternocleidomastoid muscle. In two patients; one with a large hematoma after biopsy and a second with a very large multinodular goiter, the precise localization was compromised.
Discussion & Conclusion: F18- Fluorocholine (FCH) PET/MR is a promising emerging modality for localizing parathyroid adenoma.