Role of 11C-choline PET/CT in parathyroid adenomas’ localization in patients with primary hyperparathyroidism

Background. Topical diagnosis of primary hyperparathyroidism (PHPT) remains an urgent problem due to the high incidence of persistence and recurrence after surgical treatment. At the preoperative stage, a search for the parathyroid hormone hyperproduction source is performed using instrumental methods: ultrasound, scintigraphy of the parathyroid glands (PTG) and multislice computed tomography (MSCT). The cause of PHPT persistence and recurrence after parathyroidectomy may be the multiple nature of PTG lesions or their ectopic location. Additional methods of visualization of PTG adenomas can be used to improve diagnosis (PET/CT).

Objective. To compare the sensitivity and specificity of PET/CT with 11C-choline with the traditional visualization techniques.

Design and methods. 16 PHPT patients were analyzed. All patients underwent US, subtraction scintigraphy with 99mTc-technetril/99mTc-pertechnitate and CT were performed in 12 and 16 patients, respectively. 11C-choline PET/CT was used for all patients. Imaging results’ coincidence of two methods were labeled as the true one.

Results. The sensitivity of PET/CT with 11C-choline was 94 %, CT, subtraction scintigraphy with 99mTc-technetril/99mTc-pertechnitate and US — 75 %, 69 % and 63 %, respectively. The specificity of PET/CT with 11C-choline, CT, scintigraphy with 99mTc-technetril/99mTc-pertechnitate, and US was 100 %, 84 %, 76 %, and 68 %, respectively.

Conclusion. PET/CT with 11C-choline demonstrated best sensitivity and specificity among all methods and can become an alternative in PHPT diagnostics in case of negative or inconvclusive results of previous visualization.

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