Related Experiment Video
Updated: Jun 27, 2025
Generation of Hypoparathyroid Rats via Carbon-Nanoparticle-Assisted Parathyroidectomy
Published on: July 14, 2023
Use of [18F]fluorocholine PET/CT in the detection of primary hyperparathyroidism in paediatrics: a case report
Helena Martínez Sánchez1, Francisca Moreno Macián2, Sara León Cariñena2
1Department of Pediatrics, Hospital La Fe, Valencia, Spain.
Insights
[18F]fluorocholine PET/CT is a promising imaging tool for detecting parathyroid adenomas in children when conventional methods fail. This advanced imaging can help diagnose primary hyperparathyroidism in pediatric patients, leading to timely surgical intervention and normalized hormone levels.
Area of Science:
- Endocrinology
- Nuclear Medicine
- Pediatric Surgery
Background:
- Primary hyperparathyroidism (PPH) in children, often caused by parathyroid adenoma, presents with higher morbidity than in adults.
- Traditional imaging for PPH includes cervical ultrasound and 99mTc-sestamibi SPECT/CT.
- [18F]fluorocholine PET/CT shows higher sensitivity in adults but its pediatric role is less defined.
Observation:
- A 13-year-old female with suspected PPH presented with lithiasis, elevated PTH, hypercalcemia, and hypophosphatemia.
- Conventional imaging (ultrasound, SPECT/CT) failed to localize the hyperfunctioning parathyroid glands.
- [18F]fluorocholine PET/CT successfully identified a hypermetabolic nodular lesion consistent with a parathyroid adenoma.
Findings:
- [18F]fluorocholine PET/CT detected a parathyroid adenoma missed by conventional imaging.
- Surgical removal of the adenoma led to normalized PTH levels.
- Pathological anatomy confirmed the diagnosis of parathyroid adenoma.
Implications:
- [18F]fluorocholine PET/CT can be a valuable tool for diagnosing PPH in pediatric cases with inconclusive conventional imaging.
- This technique may improve diagnostic accuracy and guide surgical treatment for pediatric parathyroid adenomas.
- Further research into the utility of [18F]fluorocholine PET/CT in pediatric PPH is warranted.
Objectives:
The most common cause of primary hyperparathyroidism (PPH) in children is a parathyroid adenoma. Among this population, PPH exhibits higher levels of morbidity, severity and target organ involvement compared to adults. When there is suspicion of PPH, cervical ultrasound and 99mTc-sestamibi SPECT/CT are the imaging test traditionally indicated. Among adults, the use of [18F]fluorocholine PET/CT has shown a higher sensitivity than ultrasound and [99mTc]sestamibi SPECT/CT, leading to an expanding adoption in recent years. However, its role in paediatrics has not been clearly defined yet.
Case Presentation:
The patient is an adolescent female aged 13 years presented with lithiasis. The analytical study revealed elevated PTH, hipovitaminosis D, hypercalcaemia and hypophosphataemia. Due to the suspicion of PPH, cervical ultrasound and 99mTc-sestamibi SPECT/C were performed, failing to identify hyperfunctioning parathyroid glands. We proceeded to carry out a [18F]fluorocholine PET/CT where a hypermetabolic nodular image was identified, compatible with a hyperfunctioning parathyroid adenoma. The patient underwent surgery, resulting in the normalisation of PTH levels. Pathological anatomy confirmed the presence of a parathyroid adenoma.
Conclusions:
In cases where conventional imaging tests yield negative results or discrepancies, we suggest the possibility of the use of [18F]fluorocholine PET/CT for the detection of hyperfunctioning parathyroid adenomas.
Related Concept Videos
01:29Positron Emission Tomography
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body...
01:25Imaging Studies II: Positron Emission Tomography and Scintigraphy
Fundamental Principles of PET
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...