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Primary hyperparathyroidism: preoperative parathyroid imaging with regional body FDG PET
D R Neumann1, C B Esselstyn, W J MacIntyre
1Department of Nuclear Medicine, Cleveland Clinic Foundation, OH 44195-5074.
Purpose:
To explore the feasibility of use of positron emission tomography (PET) with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) to localize abnormal parathyroid tissue.
Materials And Methods:
Regional body FDG PET with attenuation correction was performed in 17 adult patients with primary hyperparathyroidism (HPT) prior to surgical neck exploration. The regional body FDG PET results were correlated with surgical and histopathologic findings.
Results:
Surgical neck exploration revealed 18 parathyroid adenomas in 16 patients and four hyperplastic parathyroid glands in one patient. Regional body FDG PET allowed correct localization of 17 of the 18 parathyroid adenomas (94% sensitivity) and two of the four hyperplastic parathyroid glands (50% sensitivity). Three false-positive FDG PET findings were encountered, including two follicular thyroid adenomas.
Conclusion:
Regional body FDG PET is a promising procedure for preoperative localization of pathologic parathyroid tissue in patients with primary HPT.