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Regional body FDG-PET in postoperative recurrent hyperparathyroidism

D R Neumann1, C B Esselstyn, W J MacIntyre

  • 1Department of Nuclear Medicine (Division of Radiology), Cleveland Clinic Foundation, OH 44195-5074, USA.

Journal of Computer Assisted Tomography
|January 1, 1997
PubMed
Summary

Fluorodeoxyglucose-positron emission tomography (FDG-PET) shows promise for locating hyperfunctioning parathyroid tissue in patients with recurrent hyperparathyroidism. This imaging technique can aid in planning reoperative surgery for persistent or recurrent hyperparathyroidism.

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Area of Science:

  • Endocrinology
  • Nuclear Medicine
  • Surgical Oncology

Background:

  • Persistent or recurrent hyperparathyroidism after initial surgery necessitates reoperation.
  • Preoperative imaging is crucial for improving success rates and minimizing morbidity in reoperative parathyroid surgery.

Purpose of the Study:

  • To evaluate the effectiveness of Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) in localizing hyperfunctioning parathyroid tissue before reoperation for persistent or recurrent hyperparathyroidism.

Main Methods:

  • Twenty patients with biochemical evidence of recurrent or persistent hyperparathyroidism underwent regional body FDG-PET imaging of the neck and upper chest.
  • Imaging was performed 45 minutes after intravenous administration of 5-10 mCi FDG.

Main Results:

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  • FDG-PET correctly identified 79% of parathyroid adenomas and the single parathyroid carcinoma.
  • Sensitivity for hyperplastic glands was 29%, and the scan was negative in 79% of normal glands.
  • The positive predictive value was 64% due to eight false-positive findings.

Conclusions:

  • Regional body FDG-PET is a potentially valuable tool for evaluating patients with persistent or recurrent hyperparathyroidism.
  • Further studies are warranted to confirm its utility in guiding reoperative parathyroid surgery.