18F-FDG PET rarely provides additional information to 11C-methionine PET imaging in hyperparathyroidism

TY - JOUR

T1 - 18F-FDG PET rarely provides additional information to 11C-methionine PET imaging in hyperparathyroidism

AU - Chicklore, Sugama

AU - Schulte, Klaus-Martin

AU - Talat, Nadia

AU - Hubbard, Johnathan G

AU - O'Doherty, Michael

AU - Cook, Gary J R

PY - 2014/3

Y1 - 2014/3

N2 - AIM: The aim of this study was to assess the utility of combined C-methionine and F-FDG PET/CT imaging in hyperparathyroidism.PATIENTS AND METHODS: We reviewed all scans performed for hyperparathyroidism with both C-methionine and F-FDG PET/CT or PET in our institution since 1993. Forty-three patients (47 pairs of scans) were included (13 men and 30 women) with a mean age of 63 years. C-methionine and F-FDG PET/CT scans were classified as positive or negative for localization of abnormal parathyroid tissue, and the site of uptake was noted in the positive scans. Other concurrent imaging (Tc-MIBI scintigraphy, ultrasonography, CT, or MRI) findings were also noted when performed. Clinical follow-up information was available in 27 patients (30 episodes).RESULTS: Of the 47 PET scan episodes, 23 (49%) were positive. Twenty-two C-methionine scans showed abnormal focal localization of which 10 also showed concordant abnormal F-FDG uptake. One patient was positive with F-FDG and negative with C-methionine.Of the 16 patients who underwent subsequent surgery, 6 had concordant C-methionine, F-FDG, and surgical findings; 6 had concordant C-methionine and surgical findings; 1 had concordant F-FDG and surgical findings; and 3 had both PET scans negative but had adenomas excised during surgery.Of the 3 with both PET scans negative and discordant surgical findings, 1 had mediastinal parathyroid lipoadenoma excised and 2 had normally sited parathyroid adenoma excised.CONCLUSIONS: F-FDG PET/CT rarely provides additional information and could be saved for patients in whom C-methionine PET/CT is negative.

AB - AIM: The aim of this study was to assess the utility of combined C-methionine and F-FDG PET/CT imaging in hyperparathyroidism.PATIENTS AND METHODS: We reviewed all scans performed for hyperparathyroidism with both C-methionine and F-FDG PET/CT or PET in our institution since 1993. Forty-three patients (47 pairs of scans) were included (13 men and 30 women) with a mean age of 63 years. C-methionine and F-FDG PET/CT scans were classified as positive or negative for localization of abnormal parathyroid tissue, and the site of uptake was noted in the positive scans. Other concurrent imaging (Tc-MIBI scintigraphy, ultrasonography, CT, or MRI) findings were also noted when performed. Clinical follow-up information was available in 27 patients (30 episodes).RESULTS: Of the 47 PET scan episodes, 23 (49%) were positive. Twenty-two C-methionine scans showed abnormal focal localization of which 10 also showed concordant abnormal F-FDG uptake. One patient was positive with F-FDG and negative with C-methionine.Of the 16 patients who underwent subsequent surgery, 6 had concordant C-methionine, F-FDG, and surgical findings; 6 had concordant C-methionine and surgical findings; 1 had concordant F-FDG and surgical findings; and 3 had both PET scans negative but had adenomas excised during surgery.Of the 3 with both PET scans negative and discordant surgical findings, 1 had mediastinal parathyroid lipoadenoma excised and 2 had normally sited parathyroid adenoma excised.CONCLUSIONS: F-FDG PET/CT rarely provides additional information and could be saved for patients in whom C-methionine PET/CT is negative.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Female

KW - Fluorodeoxyglucose F18

KW - Follow-Up Studies

KW - Humans

KW - Hyperparathyroidism

KW - Male

KW - Methionine

KW - Middle Aged

KW - Parathyroid Neoplasms

KW - Positron-Emission Tomography

KW - Radiography

U2 - 10.1097/RLU.0000000000000340

DO - 10.1097/RLU.0000000000000340

M3 - Article

C2 - 24445273

SN - 0363-9762

VL - 39

SP - 237

EP - 242

JO - Clinical Nuclear Medicine

JF - Clinical Nuclear Medicine

IS - 3

ER -