fluorocholine and Multiple-Endocrine-Neoplasia-Type-1

Topics: Choline; Humans; Hyperparathyroidism, Primary; Multiple Endocrine Neoplasia Type 1; Parathyroid Glands; Positron Emission Tomography Computed Tomography; Retrospective Studies; Technetium Tc 99m Sestamibi

Retrospective analysis of a cohort of MEN1 patients with HPT1 assessed by parathyroid US, sestaMIBI scintigraphy and SPECT/CT, and FCH-PET/CT for potential surgery between 2015 and 2019.. Twenty-two patients with a confirmed diagnosis of MEN1 who presented with HPT1 and were assessed by the 3 imaging modalities were included. After imaging workups, 11 patients were operated on for the first time, 4 underwent a redo surgery, and 7 did not undergo an operation. The overall patient-based positivity rate of imaging was 91% (20 of 22) for parathyroid US and 96% (21 of 22) for both sestaMIBI and FCH-PET/CT. The 3 imaging modalities demonstrated negative findings in 1/22 patient who did not undergo surgery. Overall, 3 pathologic glands were not detected by any imaging technique. SestaMIBI and FCH-PET/CT both resulted in the same 3 false-positive results in ectopic areas with a significant uptake on two thymic carcinoid tumors and one inflammatory lymph node. FCH-PET/CT provided more surgically relevant data than sestaMIBI in 4/11 patients with initial surgery and in 1/4 patient who underwent redo surgery.. Compared to sestaMIBI scintigraphy, FCH-PET/CT provides additional information regarding the number of pathologic parathyroid glands and their localization in MEN1 patients with HPT1.

Topics: Adolescent; Adult; Aged; Choline; Female; Humans; Hyperparathyroidism, Primary; Male; Middle Aged; Multiple Endocrine Neoplasia Type 1; Parathyroid Glands; Positron Emission Tomography Computed Tomography; Radionuclide Imaging; Retrospective Studies; Technetium Tc 99m Sestamibi; Young Adult