Regional body FDG-PET in postoperative recurrent hyperparathyroidism

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:

• 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.