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A Hungry Bone Syndrome Predicted by 18F-Fluorocholine PET/CT
Anne-Cécile Paepegaey1,2, Fritz-Line Velayoudom3, Selma Housni1,2
1From the Department of Endocrinology, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University.
Predicting hungry bone syndrome (HBS) after primary hyperparathyroidism (PHPT) surgery is difficult. Intense bone uptake on F-fluorocholine PET/CT may predict severe HBS in PHPT patients.
Area of Science:
- Nuclear Medicine
- Endocrinology
- Skeletal Metabolism
Background:
- Primary hyperparathyroidism (PHPT) management involves surgical cure.
- Predicting hungry bone syndrome (HBS) post-parathyroidectomy remains a clinical challenge.
- F-fluorocholine PET/CT is utilized for parathyroid imaging.
Observation:
- A patient with PHPT exhibited intense, diffuse F-fluorocholine uptake in the skeleton preoperatively.
- The imaging also revealed a hyperfunctioning parathyroid gland.
- Following parathyroid adenoma removal, the patient developed severe, prolonged HBS.
Findings:
- Intense and diffuse skeletal F-fluorocholine uptake was observed in a PHPT patient.
- This pattern of uptake correlated with the development of severe HBS post-surgery.
- The findings suggest F-fluorocholine PET/CT may serve as a predictive tool for HBS.
Implications:
- F-fluorocholine PET/CT imaging could identify PHPT patients at high risk for HBS.
- Preoperative risk stratification may allow for proactive management of HBS.
- This imaging modality may improve patient outcomes after parathyroid surgery.
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