Hyperparathyroidism Clinical Trial
Official title:
Diagnostic Value of 18F-fluorocholine PET/CT Imaging in Localization of Hyperfunctioning Parathyroid Tissue in Hyperparathyroidism
To assess the efficiency of 18F-fluorocholine PET/CT in localization of hyperfunctioning parathyroid tissue in hyperparathyroidism, thereby enabling minimally invasive surgical approaches with fewer complications and comparable success rates
Primary hyperparathyroidism is a common endocrine disorder for which the diagnosis is
biochemical and therapy surgical in the vast majority of cases; in secondary and tertiary
hyperparathyroidism, surgical treatment is usually chosen when conservative measures fail to
control the condition. The previously used surgical approach of bilateral neck exploration is
being replaced by minimally invasive procedures, whose advantage is shorter duration of
operation and general anesthesia, lower morbidity and fewer complications with comparable
success rates.
A prerequisite for minimally invasive surgery is successful localization of the offending
parathyroid tissue. Most commonly used imaging modality for this purpose is parathyroid
scintigraphy with 99mTc-sestaMIBI, usually supplemented by ultrasound of the neck. Overall,
parathyroid scintigraphy is a sensitive method for localization of hyperfunctioning
parathyroid tissue; however, its diagnostic performance is significantly lower in patients
with multiple parathyroid lesions.
In comparison to conventional nuclear medicine imaging approaches for localization of the
offending parathyroid tissue, positron emission tomography with computed tomography (PET/CT)
offers superior image resolution with an additional advantage of attenuation correction and
co-registration of functional and anatomical information. 18F-fluorocholine is a PET tracer
which is commonly used for prostate cancer imaging. In contrast to 18F-fluorodeoxyglucose
(18F-FDG), it is also taken up by well-differentiated neoplasms in which 18F-FDG uptake is
unreliable. The investigators hypothesize that 18F-fluorocholine might be efficiently taken
up by parathyroid adenomata and/or hyperplasia.
The aim of this study is to investigate the efficiency of localization of hyperfunctioning
parathyroid tissue with 18F-fluorocholine PET/CT in patients with primary hyperparathyroidism
and to compare its efficiency to conventional scintigraphic imaging methods for this purpose.
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