Feasibility of Hyperfunctioning Parathyroid Gland Localization Using [¹⁸F]fluciclovine PET/CT

Area of Science:

• Nuclear Medicine
• Radiopharmacology
• Endocrinology

Background:

• Hyperparathyroidism diagnosis relies on accurate localization of hyperfunctioning parathyroid glands.
• Conventional imaging techniques have limitations in precisely identifying these glands.

Purpose of the Study:

• To compare the efficacy of [18F]fluciclovine PET/CT with [99mTc]sestamibi SPECT/CT for localizing hyperfunctioning parathyroid glands.

Main Methods:

• Four patients with hyperparathyroidism underwent sequential neck and thorax PET/CT after [18F]fluciclovine injection.
• Lesion uptake and target-to-background ratios (TBR) were compared with [99mTc]sestamibi SPECT/CT in the same patients.

Main Results:

• Both imaging modalities detected 4 out of 5 hyperfunctioning parathyroid glands.
• [99mTc]sestamibi demonstrated significantly higher TBRs compared to [18F]fluciclovine, indicating better gland conspicuity.
• [18F]fluciclovine showed rapid washout with highest uptake and TBRs at 5-9 minutes post-injection.

Conclusions:

• [18F]fluciclovine PET/CT can detect hyperfunctioning parathyroid glands in early imaging.
• [99mTc]sestamibi SPECT/CT provides superior target-to-background ratios for parathyroid gland localization.
• [18F]fluciclovine PET/CT may not be as promising as [99mTc]sestamibi SPECT/CT for this specific diagnostic application.